SAFE-D Certified Emergency Services Commissioner Application

SAFE-D Certified Emergency Services Commissioner

Please fill out the application below.
You may fill out only the portions relevant to the specific designation (Basic, Advanced, Distinguished) for which you are applying. For more on the CESC program, go to: www.safe-d.org/cesc.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What county do you live in?
ESD Name (e.g., Buffalo County ESD No. 99)
Email
example@example.com
Phone Number

Area CodePhone Number
CESC BASIC - I affirm the following requirements to be a Certified Emergency Services Commissioner:
CESC ADVANCED - I affirm the following requirements to be a Certified Emergency Services Commissioner - Advanced:
CESC DISTINGUISHED - I affirm the following requirements to be a Certified Emergency Services Commissioner - Distinguished:
I have taken a course in ALL of the following required "core competencies":
I have participated in the following legislative activities:
Please list the number of times you have participated in a SAFE-D Capitol Event
Please list the number of documented contacts you have had with your member of the Texas Legislature (Representative/Senator) or a member of the Texas Executive Branch
Upload proof of timely submission of your ESD's audit here (this could be a page from your ESD meeting minutes, a cover page/letter from your auditor, proof of filing with your County, etc.)

Browse Files

Cancelof
Signature
Thanks for your interest in becoming a SAFE-D Certified Emegrency Services Commissioner. SAFE-D usually recognizes the new class of CESCs at the Annual Conference. Please be on the lookout for more information about your application via email.
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