Application For Training
Instructions:
1. Please print this form and fill in all the required information and send to the address below along with the Registration Form, Deposit, and Credential. If you have paid the deposit or full course fees Online via credit card, this form and the credential will need to be sent in addition. The Credential is only required if you are a first time attendee.
Credential. (Copy of Hazardous Devices, Explosive Ordnance Disposal School or other explosive training diploma. Letter of reference from supervisor attesting to good moral character).
Course(s) to be taken: ____________________________________________
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Date of course: from ________ to ________, from ________ to ________
Second choice if class is full: from _______ to ________
2. By signing this application, I understand and agree:
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a. That my Credential enclosed meets the requirements as outlined by Rapid Entry Systems Technology Corp., and that I must positively identify myself as the same person certified in the Credential for enrollment.
b. Each of the courses mentioned above depend upon the careful and knowledgeable handling of explosives by each student, and such careful handling depends upon the wholehearted cooperation of its clients; therefore, I understand that my instruction may be terminated at any time during the course if my cooperation is not deemed satisfactory by the staff.
c. That I will abide by any and all safety procedures and precautions required while attending either course, and that I agree to sign a statement releasing Rapid Entry Systems Technology Corp. and Gunsite Training Center, Inc. from any injury I might sustain during the training program.
d. That I will be at least 18 years of age at the time training begins.
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My deposit for half the tuition is enclosed or has been processed Online. I understand that if my class is cancelled, my deposit is fully refundable. If I cancel at least 60 days prior to the first day of class, one-half of my deposit is refundable OR the full deposit can be applied to hold a seat in a later class. If I cancel with less than 60 days before the beginning of my confirmed class, my deposit becomes totally NON-REFUNDABLE OR half of my deposit can be applied to another available class.
Name: __________________________ Rank: _________ Phone: (___)_____________
Address: _________________________________ City: _________________________
State: ______ Zip: ____________ E-mail: ____________________________________
Signature:____________________________________________ Date:______________
Rapid Entry Systems Technology Corp. (REST. CORP.)
P.O. Box 7093, Yuma, AZ. 85366
Questions: call (928) 329-7555
Fax: (928) 329-7556