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Create Nomination Form for Introduction to Fire Effects - CA_RX310_02-22-2010_#1038

Training Officers: This session uses the IQCS Nomination Workflow process.
Part One

Before proceeding, click the yellow Help button in the right corner and read the Help Topic, 'Online Nomination Form - Overview'.

Course Session
Information
Course Code: RX310    Course Name: Introduction to Fire Effects
IQCS Session #: 91    Location: McClellan, CA
Start Date: 2-22-2010    End Date: 2-26-2010
Tuition: $450.00
Coordinator
Information
Name: WFTC Training Center
Email: wftc@fs.fed.us
Phone: 916-640-1112
Fax: 916-640-1191
Nominee
Information
All Nominees in IQCS must provide their IQCS Emplid number. No number is required for those Nominees who are not in IQCS.
REQUIRED. First Name - Middle Initial - Last Name
Provide a valid email address.
REQUIRED. Provide name of agency where Nominee is employed.
Home Unit
Information
REQUIRED.
REQUIRED.
REQUIRED.
REQUIRED.
REQUIRED.
REQUIRED. Format - 555-555-5555
Format - 555-555-5555
Nominee
Address
Provide Nominee address information only if different than Home Unit Address.
Format - 555-555-5555 Provide a phone number where Nominee can be reached.
Nominee
Training and
Qualifications
REQUIRED. List training and dates completed pertinent to this Course.
REQUIRED. List your past qualifications pertinent to this Course.
Add other pertinent information if any.
Part Two
There is a tuition charge for this Course Session. You MUST complete one of the sections below or your Nomination Form will not be accepted.

Please check the section appropriate to the legal authority to collect monies and complete the billing address block.
When completed, this form must be signed by an individual with authority to sign agreements and obligate the funds listed.
Note: Tribal governments are not covered by the Intergovernmental Cooperation Act of 1968.

PMS 921-2(799) NFES-2131 Nom form

PART II - AGREEMENT TO COLLECT FUNDS (Complete only if there is a tuition charge)

Course Name: Introduction to Fire Effects    Tuition: $450.00

Non-Federal
Agency
Information

Contractor, states, governments engaged in fire suppression and protection of public lands. This training, payment and collection is duly authorized under the Intergovernmental Cooperation Act of 1968 as amended by the act of September 13, 1982 (P.L.97-258), Section 6505. The NWCG Interagency Training Nomination constitutes written request and it is understood the bill for the training will consist of tuition plus all other identifiable costs as provided by law. Authorizing signature is also certifying services requested cannot be procured reasonably and expeditiously through ordinary business channels and funds are available. Provider's signature certifies the agency is offering similar services for its own use.

Provide Charge Code. Include required fiscal references.
Other
Federal
Agency

This training, payment, and collection is duly authorized under Section 601 of the Economy Act of June 30, 1932 (31 USC 1535) as amended. The NWCG Interagency Training Nomination constitutes the required written request and it is understood the bill for the training will consist of tuition plus all other identifiable costs as provided by law. Authorizing signatures is also certifying servies requested are in the best interest of the United States; cannot be procured by contract as conveniently or cheaply from a commercial source and appropriate funds are available for this purpose. Provider's signature certifies the agency is offering similar services for its own use.

Include agency location.
Same
Agency
Provider

The NWCG Interagency Training Nomination constitutes agreement to pay charges as outlined in nomination materials. Authorizing signature certifies funds are available for this purpose.

Provide Charge Code. Include Override.
Billing
Information
Provide Billing Name and Address if different than Sponsor or Agency Name and Address.

PLEASE NOTE: The signature blocks will appear on the completed form.

Create Your
Nomination
Form
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