GFD Staffing Form

GFD STAFFING STIPEND FORM

0700 - 1500 | 2100 - 0600
Captain:
1. Submit the form: If someone from your station worked a duty shift, you must submit the staffing form.
2. Timing: This needs to be done by Monday of the following week in order for the shift to qualify for the stipend.
3. Stipend Eligibility: The stipend provides 50 points for each qualifying shift.
4. Even for a Single Member: If only one person from your station worked a duty shift, you still need to submit the form to qualify – one sheet per week from each station if applicable.
Make sure to keep track of your duty shifts and get the form in on time! If you need help formatting or understanding the form itself, feel free to ask!
The Daylight ModuleThe Midnight Module
For station: *
- Daylight Staffing Cheat Sheet
- Daylight Module
- Week Ending Date *
  
  YearMonthDay
  Date of Sunday after the staffing
- Week Number*
  If unsure, see master Matrix sent by C-4
- Monday Driver/Operator Name*
  If none, type none
- Monday Driver/Operator Badge #*
  If none, type 000
- Tuesday Driver/Operator Name*
  If none, type none
- Tuesday Driver/Operator Badge #*
  If none, type 000
- Wednesday Driver/Operator Name*
  If none, type none
- Wednesday Driver/Operator Badge #*
  If none, type 000
- Thursday Driver/Operator Name*
  If none, type none
- Thursday Driver/Operator Badge #*
  If none, type 000
- Friday Driver/Operator Name*
  If none, type none
- Friday Driver/Operator Badge #*
  If none, type 000
- The Station Captain’s signature attests that the staffing shift was manned by the firefighter indicated. The final submission is completed by the Fire Department Administrator, who relies on the Captain’s verification. The Administration reports solely based on the information provided by the Captain to the Relief Association.
  
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- Certifiying Captain*
- Designee Specification
- Midnight Module
- Midnight Staffing Cheat Sheet
- Shift Date *
  
  YearMonthDay
  Date of Staffing
- Week Number*
  If unsure, see master Matrix sent by C-4
- Midnight Driver/Operator Name*
  If none, type none
- Midnight Driver/Operator Badge #*
  If none, type 000
- Midnight Mask Personnel Name*
  If none, type none
- Midnight Mask Personnel Badge #*
  If none, type 000
- The Station Captain’s signature attests that the staffing shift was manned by the firefighter indicated. The final submission is completed by the Fire Department Administrator, who relies on the Captain’s verification. The Administration reports solely based on the information provided by the Captain to the Relief Association.
  
  Powered by Jotform SignClear
- Certifiying Captain*
- Designee Specification
Should be Empty:

GFD STAFFING STIPEND FORM

Daylight Module

Midnight Module