PatRick Environmental, Inc. dba PatRick Corporation |
Training Class Request |
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| Training Selected:
Springfield, OR - 02-04-2022 - RT-130 Refresher/ Pack Test
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| *Name - Last: |
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*First: |
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Middle: |
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| *City: |
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*State: |
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*Zip: |
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| *Cell Phone: |
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*Email Address: |
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| Can you receive Text Messages? |
Yes
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Are you located 3 hours or less from our base? |
Yes
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Your Work Experience: |
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| Wildland Fire Experience: |
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| Have you been a Wildland firefighter? |
Yes |
| Do you have a copy of your certificate of training? |
Yes |
| Who were you trained by? |
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| Last Employment Experience: |
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| *Employer Name: |
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| *Employer Telephone: |
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| *Job Title: |
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| *Start Date: |
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End Date: |
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| *Work Performed: |
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| *Reason for Leaving: |
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I hereby authorize PatRick Environmental, Inc. to consult any previous employer. |
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Wildland Firefighting Disclaimers: |
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Wildland Firefighting is HARD outdoor work that includes travel. You may be gone 14-30 days at a time. This job includes sleeping outdoors, hiking miles in the forest, and hard physical labor often in steep terrain.
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| Are you physically fit? |
Yes |
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| List any reasons you may not be able to do this job? |
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| List qualifications, skills, strengths, and experience that will help you be a wildland firefighter? |
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I have read the information, understood, and truthfully answered this Inquiry. |
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| *Digital Signature (type your name): |
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Date: |
10/304/2025
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| * Indicates required fields |
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