Evaluation Worksheet for Certificate		Firefighter Academy
SID:	________________________________	Certificate of Achievement - 3180
		Effective: Fall 2022
		Public Safety
Name:	________________________________	(707) 836-2913

REQUIREMENTS: Complete 24.0 units Firefighter Academy Requirements - complete 24.0 units Course Description Units Completed In Progress Comments FIRE 71  Fire Protection Organization 3.0       FIRE 208  Introduction to Firefighter Academy 1.5       FIRE 290  Firefighter Academy 17.5         Complete any combination totaling at least 2.0 units from the following: EMC 100  Emergency Medical Responder 2.0       EMC 103  Emergency Medical Technician 7.5

	Evaluation worksheet completed upon receipt of Transfer Credit Evaluation form. Includes credit from other institutions only received to date.
	Evaluation worksheet completed for ________________________________. Includes all SRJC and transfer credit received to date.

Units completed:    __________ Units in progress:    __________ Total:    __________

Requirements Completed     Pending (work in progress)     Requirements Not Completed

Comments

Date: ________________________   By: ____________________________________________