CBBP Test Legacy Application (Form Only)

Wisconsin Certified Burn Boss Program: Legacy Application
Please make sure that you have read and understood all information in the CBBP landing page (https://prescribedfire.org/cbbp/) before proceeding. It is recommended to read through the entire application below before starting to fill out information.

Select "Save" below to save your progress (select "Skip Create an Account" if you do not wish to create a Jotform account). Please note that saved drafts are automatically deleted after 2 months OR after the application is submitted.

Contact certification@prescribedfire.org with any questions.
Section 1: Applicant Information
Name*

First NameLast Name
Employer's Name (if applicable):
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Section 2: Prescribed Burn and Training Documentation
This section requires detailed documentation of 30 prescribed burns. Up to 4 optional training courses may be listed; each completed course reduces the number of required burns by 1. Every column must be filled out for each documented burn; if the unit has no secondary fuel type, "N/A" must be selected for that column.

Burns 1 through 10 must have been completed in the Burn Boss role.

Burns 1 through 5 each require you to submit a burn unit map, as well as a completed WPFC Complexity Worksheet demonstrating a complexity score of 110 or higher and adequate rationale for that score. Instructions for completing Complexity Worksheets can be found here: https://prescribedfire.org/wp-content/uploads/WPFC-Complexity-Instructions.pdf. Download a Complexity Worksheet here: https://prescribedfire.org/wp-content/uploads/Complexity-Worksheet_v-108.xlsx

Only the following training courses are accepted:
- "Introduction to Fire Effects" (RX-310)
- "Introduction to Wildland Fire Behavior Calculations" (S-390)
- "Prescribed Fire Plan Preparation" (RX-341)
- "Prescribed Fire Implementation" (RX-301)
- "Prescribed Fire Burn Boss" (RX-300)
- A one-semester college level Fire Ecology course
- A one-semester college level Fire Behavior course
Years of Prescribed Burn Experience*
You must have at least 3 years of experience to be eligible for the Legacy Track.
Click here for help with burn unit coordinates

X

How to quickly find the coordinates of your burn unit:

1. Go to Google Maps (https://www.google.com/maps) in your computer browser

2. Locate your burn site

3. Click anywhere within the burn unit to drop a pin

4. Copy and paste the coordinates given by the pin into the CBBP application

Moderate-Complexity Burn Boss Burns*

	Unit Name	Unit Size (acres)	Date (MM/DD/YYYY)	Organization, Company, or Individual sponsoring the burn	Nearby Municipality (e.g. Madison)	County (e.g. Dane)	State Initial (e.g. WI)	Burn Unit Coordinates (Copy and paste from Google Maps)	Primary Fuel Type	Secondary Fuel Type
Burn 1
Burn 2
Burn 3
Burn 4
Burn 5

Burn 1 Complexity Worksheet and Burn Unit Map*

Please submit exactly 2 files. The complexity worksheet must show a score of 110 or higher. It is highly recommended to use the "Rationale/Mitigation Procedures" section of the Worksheet to communicate your thought process to the application reviewers, especially for elements with a complexity value of 3 or greater.
Cancelof
Burn 2 Complexity Worksheet and Burn Unit Map*

Please submit exactly 2 files. The complexity worksheet must show a score of 110 or higher. It is highly recommended to use the "Rationale/Mitigation Procedures" section of the Worksheet to communicate your thought process to the application reviewers, especially for elements with a complexity value of 3 or greater.
Cancelof
Burn 3 Complexity Worksheet and Burn Unit Map*

Please submit exactly 2 files. The complexity worksheet must show a score of 110 or higher. It is highly recommended to use the "Rationale/Mitigation Procedures" section of the Worksheet to communicate your thought process to the application reviewers, especially for elements with a complexity value of 3 or greater.
Cancelof
Burn 4 Complexity Worksheet and Burn Unit Map*

Please submit exactly 2 files. The complexity worksheet must show a score of 110 or higher. It is highly recommended to use the "Rationale/Mitigation Procedures" section of the Worksheet to communicate your thought process to the application reviewers, especially for elements with a complexity value of 3 or greater.
Cancelof
Burn 5 Complexity Worksheet and Burn Unit Map*

Please submit exactly 2 files. The complexity worksheet must show a score of 110 or higher. It is highly recommended to use the "Rationale/Mitigation Procedures" section of the Worksheet to communicate your thought process to the application reviewers, especially for elements with a complexity value of 3 or greater.
Cancelof

Other Burn Boss Burns*

	Unit Name	Unit Size (acres)	Date (MM/DD/YYYY)	Organization, Company, or Individual sponsoring the burn	Nearby municipality (e.g. Madison)	County (e.g. Dane)	State Initial (e.g. WI)	Burn Unit Coordinates (Copy and paste from Google Maps)	Primary Fuel Type	Secondary Fuel Type
Burn 6
Burn 7
Burn 8
Burn 9
Burn 10

Other Burns*

	Unit Name	Unit Size (acres)	Date (MM/DD/YYYY)	Organization, Company, or Individual sponsoring the burn	Nearby municipality (e.g. Madison)	County (e.g. Dane)	State Initial (e.g. WI)	Burn Unit Coordinates (Copy and paste from Google Maps)	Primary Fuel Type	Secondary Fuel Type	Role
Burn 11
Burn 12
Burn 13
Burn 14
Burn 15
Burn 16
Burn 17
Burn 18
Burn 19
Burn 20
Burn 21
Burn 22
Burn 23
Burn 24
Burn 25
Burn 26
Burn 27
Burn 28
Burn 29
Burn 30

Optional Training Courses (Each training course can substitute for one of the required burns 27 through 30. Enter N/A in one of these rows in the table above for each course provided.)

	Name	Offered by	Date of Completion
Course 1
Course 2
Course 3
Course 4

Please upload a certificate of completion for each course provided above.

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Section 3: References
Please provide the contact information for 2 references that can attest to your prescribed burn leadership capabilities.
Reference 1 Name*

First NameLast Name
Reference 1 Organization*
Reference 1 Email Address*
example@example.com
Reference 2 Name*

First NameLast Name
Reference 2 Organization*
Reference 2 Email Address*
example@example.com
Section 4: Signature and Payment
Before proceeding, please make sure you have read the CBBP Code of Conduct and Grounds for Sanction or Revocation of Certification.
I have read and agreed to the CBBP Code of Conduct and Grounds for Sanction or Revocation of Certification.*
Initial here
I certify that all information included in this application is true and correct.*
Initial here
Signature*

Clear

Payment

CBBP Application FeeThis nonrefundable fee is required to apply to the CBBP. An additional $55 certification fee is required upon application approval.

$105.00 Quantity

Payment Methods

Credit Card

Apple Pay

Google Pay

ACH Bank Transfer

Contact certification@prescribedfire.org for assistance with payment or any other application components. Be sure to save your progress beforehand by clicking the "Save" button below.
Should be Empty:

Wisconsin Certified Burn Boss Program: Legacy Application

Section 1: Applicant Information

Section 2: Prescribed Burn and Training Documentation

Click here for help with burn unit coordinates

How to quickly find the coordinates of your burn unit:

Section 3: References

Section 4: Signature and Payment

Payment Methods