HMRTC Class Request form

The information obtained on this form will be utilized for contact information regarding classes only. A representative from Waterloo Fire Rescue will contact you once your class and/or classroom request is approved.

You may call 319.291.4275 or e-mail hmrtc@waterloo-ia.org with any questions.

For specific questions regarding instructors or class material, please e-mail Captain David Jensson at Dave.Jensson@waterloo-ia.org.
Class Request form
I am:
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

MEETING SPACE SCHEDULER

Please contact the HMRTC at 319-291-4275 or hmrtc@waterloo-ia.org if you need additional assistance.
Northeast Iowa Response Group: Class Listings for County, Fire, EMS, and Hospital Entities

Please contact the HMRTC at 319-291-4275 or hmrtc@waterloo-ia.org if you need additional assistance.
Industry Class Request Form

Please contact the HMRTC at 319-291-4275 or hmrtc@waterloo-ia.org if you need additional assistance.
Individual/Private Class Request Form

Please contact the HMRTC at 319-291-4275 or hmrtc@waterloo-ia.org if you need additional assistance.
Quad County Prop

You will be contacted by a Quad County fire representative once your request is submitted. Please contact Andrew Hostelka at Andrew.Hostelka@waterloo-ia.org if you need additional assistance.
Upstairs room: 204
Basement Classroom
Clandestine Drug LabConfined Space AwarenessHazardous Materials Operations ClassHazardous Materials Operations EMS ClassHazardous Materials Operations RecertificationIncident Command ClassCPROther
Start Date:

MonthDayYear
Date
Ending Date if more than an 8 hour class:

MonthDayYear
Date
Time

Hour Minutes

AM/PM Option
Emergency Contact for Class:

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Location Name:
Location of the class:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Confined Space EntryConfined Space Entry (>14)Confined Space Rescue Technician 24hrConfined Space Technician RecertificationFire Extinguisher Class: Live FireFire Extinguisher Class: SimulatorHazardous Materials Technician 24hrHazardous Materials Technician 40hrHazardous Materials Technician RecertificationIndustrial Fire BrigadeIndustrial Site SurveyCPROther
Start Date

MonthDayYear
Date
Ending Date (if more than 8 hour class)

MonthDayYear
Date
Number of attendees anticipated:
YesNoOther
Thank you for your interest in fire extinguisher training.

An instructor will be in contact with you to set up the class.
CPR and First AidFire Extinguisher Class: Live FireFire Extinguisher Class: SimulatorOther
Number of participants:
CPR/First Aide Date(s) available:

MonthDayYear
Please note that classes are held on the 4th Thursday of every month from 4pm to 6pm.
Thank you for your interest in fire extinguisher training.

An instructor will be in contact with you to set up the class.
Forcible Entry TrailerBail Out Prop
YesNo
Pick-up Date

MonthDayYear
Date
Drop Off Date

MonthDayYear
Date
Emergency Contact for prop reserve:

First NameLast Name
Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Location Name:
Address of prop destination:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MorningAfternoonAll DayOther
Thank you for your request. Pleast press "Submit" and a member will contact you shortly. If you need further assistance, please call 319-291-4275 or e-mail hmrtc@waterloo-ia.org
Should be Empty:

Class Request form

MEETING SPACE SCHEDULER

Northeast Iowa Response Group: Class Listings for County, Fire, EMS, and Hospital Entities

Industry Class Request Form

Individual/Private Class Request Form

Quad County Prop