HISTORICAL CERTIFICATION REQUEST FORM

    NOTE::
  • Registrations are for those National Pro-Board certifications obtained through the PA State Fire Academy /Office of the State Fire Commisisoner in 2011 and prior.
  • Rate per Level Requested = $7.50
    CREDIT CARD PAYMENTS:
  • Please complete the form, upload relevant documents, select payment type as "Electronic Payment" and then select "Checkout" button.
  • Attach copy of relevant Certification Certificate(s)
    MAIL-IN APPLICATION:
  • Please complete the form and select Payment Type as "Mail-In Application"and then select "Submit" button.
  • Enclose a check or money order with the printed application (Payable to Commonwealth of PA).
  • Do not add documents, Please┬ámail with your completed form and fee.






Registration Level(s) Requested
Airport Firefighter Driver/Operator - Aerial
Driver/Operator - Pumper Driver/Operator – Mobile Water
Fire Inspector I Fire Investigator
Fire Officer I Fire Officer II
Fire Service Instructor I Fire Service Instructor II
Firefighter I Firefighter II
HazMat Awareness HazMat Incident Commander
HazMat Operations HazMat Technician
Industrial Fire Brigade - Advanced Exterior Industrial Fire Brigade - Incipient
Juvenile Firesetter I Public Life & Safety Educator I
Rescue Technician – Confined Space Rescue Technician – Rope
Rescue Technician – Structural Collapse Rescue Technician – Surface Water
Rescue Technician – Trench Rescue Technician – Vehicle/Machinery
Rescue Technician – Vehicle/Machinery I Rescue Technician – Vehicle/Machinery II