Academy Equipment Reservation Request

Requesting Organization

Requestor Name

Requestor Email Address

Requestor Phone Number

Phone

Type of Training

IDHS Funded Training

Certification Training

Department Training

Recruit School

Department/Training Location

Projected Number of Students

Please indicate your top three preferred time ranges.

Note: Three time ranges are required. Sharing your schedule flexibility helps Academy staff better accommodate all requests that are received for the quarter. If your training dates are not flexible at all, please put the same start and end dates for all three preferences, but understand that having only one date range increases the risk of your request being unable to be fulfilled.

Preference 1: Start Date

mm/dd/yyyy

Preference 1: End Date

mm/dd/yyyy

Preference 2: Start Date

mm/dd/yyyy

Preference 2: End Date

mm/dd/yyyy

Preference 3: Start Date

mm/dd/yyyy

Preference 3: End Date

mm/dd/yyyy

Justification

Provide any details that may help Academy staff better understand your request. This may include details about the date preferences you selected.

Open Training

Mark this checkbox if you want other departments to contact you to schedule training while the requested equipment is at your facility.

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