Name
(Required)
First
Last
Student ID
(Required)
Fire Department
(Required)
Current Rank
(Required)
Years in Position
(Required)
Mobile Phone Number
(Required)
Country
Phone Number
Email
(Required)
Preferred Email
Date of Last Credential
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CATEGORY 1: NEW CODE ORIENTATION TRAINING COURSE REQUIREMENT
As of 01/01/23, the Department of Fire Services’ course #NC3 is REQUIRED
Max Hours Awarded FPORC: 2
New Code Orientation
(Required)
Date Completed
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Your Hours
Max hours: 2
Please enter a number less than or equal to
2
.
New Code Orientation Completion Certificate
(Required)
Please upload a PDF of your completion certificate.
Drop files here or
Select files
Max. file size: 1 MB, Max. files: 1.
CATEGORY 2: PROFESSIONAL DESIGNATION: CENTER FOR PUBLIC SAFETY EXCELLENCE (CPSE)
The Commission recognizes the Center for Public Safety Excellence (“CPSE”) Fire Marshal Designation Credential as satisfying the requirements and standards set forth by the Massachusetts Fire Chief Credential /or Re-credential Designation program.
Enter date designation was awarded during the 36-month recredential period
Attach copy of certificate
Max Hours Awarded FPORC: 58
CPSE Fire Marshal
Date Completed:
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Your Hours
Max Hours: 58
Please enter a number less than or equal to
58
.
Attestation - 36 Month
Attest that these are completed within 36 months recredential period and not prior to last credential date.
I agree
CPSE Fire Marshal - Certificate Upload
Drop files here or
Select files
Max. file size: 1 MB, Max. files: 1.
CATEGORY 3: FORMAL EDUCATION
Degrees or education certificate must be from an accredited institution
Degree can be in any subject for credit
No credit will be awarded for partial completion of degree
Include ALL levels attained
Enter date certificate or degree was attained during the 36-month recredential period
Attach copies of certificates or degrees
(MUST scan all files into 1 document for category upload)
Max Hours Awarded FPORC: 20
Category 3 Credentials
Select all that Apply
College Certificate - 3 Hours
Associates - 5 Hours
Bachelors - 10 Hours
Masters - 15 Hours
Doctorate PhD - 20 Hours
Your Hours
Max Hours: 20
Please enter a number less than or equal to
20
.
Attestation - 36 Month
Attest that these are completed within 36 months recredential period and not prior to last credential date.
I agree
Category 3 - Certificate Upload
Please combine all applicable documents into a single document for upload.
Drop files here or
Select files
Max. file size: 2 MB, Max. files: 1.
CATEGORY 4: PROFESSIONAL CERTIFICATIONS: FIRE OFFICER
Certifications can be issued by Federal, State, NFPA, or other certifying entities
This is
not
the Training Program completion – must be certified
Credit for fire examinations will only be awarded if a passing score is achieved
Include ALL levels attained
Enter dates certifications were awarded during the 36-month recredential period
Attach copies of certificates
(MUST scan all files into 1 document for category upload)
Max Hours Awarded FPORC: 20
Category 4 Credentials
Select all that apply
Fire Officer 1 - 5 Hours
Fire Officer 2 - 10 Hours
Fire Officer 3 - 15 Hours
Fire Officer 4 - 20 Hours
Your Hours
Max Hours: 20
Please enter a number less than or equal to
20
.
Attestation - 36 Month
Attest that these are completed within 36 months recredential period and not prior to last credential date.
I agree
Category 4 - Certificate Upload
Please combine all applicable documents into a single document for upload.
Drop files here or
Select files
Max. file size: 2 MB, Max. files: 1.
CATEGORY 5: PROFESSIONAL CERTIFICATIONS
Certifications can be issued by Federal, State, NFPA, or other certifying entities
This is
not
the Training Program completion – must be certified
Credit for fire examinations will only be awarded if a passing score is achieved
Enter dates certifications were awarded during the 36-month recredential period
Attach copies of certificates (MUST scan all files into 1 document for category upload)
Max Hours Awarded FPORC: 20
Untitled
Fire Inspector 1 (NFPA or Pro Board) - 10 Hours
Fire Inspector 2 (NFPA or Pro-Board) - 15 Hours
Fire Instructor 1 - 5 Hours
Fire Instructor 2 - 10 Hours
Fire Instructor 3 - 15 Hour
Fire Investigator (Pro-Board) - 5 Hours
Incident Safety Officer - 10 Hours
Fire and Life Safety Educator - 15 Hours
Your Hours
Max Hours: 20
Please enter a number less than or equal to
20
.
Attestation - 36 Month
Attest that these are completed within 36 months recredential period and not prior to last credential date.
I agree
Category 5 - Certificate Upload
Please combine all applicable documents into a single document for upload.
Drop files here or
Select files
Max. file size: 3 MB, Max. files: 1.
CATEGORY 6: PROFESSIONAL MEMBERSHIPS
Membership Organizations must be fire prevention related
Enter dates of active membership during the 36-month recredential period
Attach copies of membership cards or letter acknowledging membership
(MUST scan all files into 1 document for category upload)
2 hours awarded per year served per membership
Max Hours Awarded FPORC: 10
Professional Contributions
Examples of approved organizations include: Board of Fire Prevention Regulations, Hazardous Materials Advisory Board, NFPA Technical Committees, etc. special related task forces
Organization Name (2 hours / year)
Dates
Your Hours
Add
Remove
Attestation - 36 Month
Attest that these are completed within 36 months recredential period and not prior to last credential date.
I agree
Category 6 - Certificate Upload
Please combine all applicable documents into a single document for upload.
Drop files here or
Select files
Max. file size: 2 MB, Max. files: 1.
CATEGORY 7: PROFESSIONAL DEVELOPMENT: TRAININGS/COURSES
The
Approved Trainings List
includes all training that have been evaluated for credit
ALL
trainings listed in your application
MUST
have an approval # and credit awarded on the
Approved Trainings List
If there is a training that does not appear on the
Approved Trainings List
with credit or you would like to challenge the awarded credit, you
MUST
submit a
Training Request for Credit Application
and receive an approval # prior to including the training in your portfolio
Do
NOT
include the original Fire Prevention Officer course you completed in order to attain your initial credential designation
Enter dates trainings were completed during the 36-month recredential period
Attach copies of education transcript(s) OR certificates (MUST scan all files into 1 document for category upload)
Max Hours Awarded FPORC: 58
Approved Training - Please List
Examples of approved organizations include: Accredited colleges or universities (if not counted in a degree for which you have previously received hours), fire attack schools, weekend seminars or workshops, Massachusetts Firefighting Academy, National Fire Academy, chiefs’ conferences, vendor courses, and other learning institutions.
Approval #
Training Title
Date Completed
Your Hours
Add
Remove
Attestation - 36 Month
Attest that these are completed within 36 months recredential period and not prior to last credential date.
I agree
Category 7 - Certificate Upload
Please combine all applicable documents into a single document for upload.
Drop files here or
Select files
Max. file size: 6 MB, Max. files: 1.
CATEGORY 8: PROFESSIONAL CONTRIBUTIONS: BOARDS/COMMISSIONS/TECHNICAL COMMITTEES
Contributions must be fire prevention related
Contributions must be based on regional or statewide service and evidence of benefit to the fire service or the public as a whole
Enter dates of active involvement during the 36-month recredential period
Attach letter
acknowledging role on board/committee
(MUST scan all files into 1 document for category upload)
4 hours awarded per year served per organization
Max Hours Awarded FPORC: 24
Professional Contributions
Examples of approved organizations include: Board of Fire Prevention Regulations, Hazardous Materials Advisory Board, NFPA Technical Committees, etc. special related task forces
Organization Name (4 hours / year)
Dates
Your Hours
Add
Remove
Attestation - 36 Month
Attest that these are completed within 36 months recredential period and not prior to last credential date.
I agree
Category 8 - Certificate Upload
Please combine all applicable documents into a single document for upload.
Drop files here or
Select files
Max. file size: 3 MB, Max. files: 1.
Attestation
(Required)
I understand that credentialing is subject to the approval of the State Fire Marshal. I will execute the necessary documents and supply further information as determined by The State Fire Marshal. I understand that any false statements or misrepresentation submitted in the course of these proceedings may result in the revocation of my Fire Prevention Officer Credential designation. I hereby attest that I am currently an active member in good standing of the Massachusetts Fire Service and give permission for verification of any information provided in this application.
Select exactly
1
choice.
I agree
Full Name - Attestation
(Required)