Form Gen 1389 - Functional Assessment Service Team (Fast) Leader Course Application
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1FUNCTIONAL ASSESSMENT SERVICE TEAM (FAST) LEADER
COURSE APPLICATION
NAME:
TITLE:
AGENCY/ORGANIZATION:
GOV
/
NGO
(CIRCLE ONE)
WORK PHONE:
E-MAIL:
WHICH TRAINING LOCATION/DATES ARE YOU PLANNING TO ATTEND?
MY TRAINING, EXPERIENCE, AND QUALIFICATIONS INCLUDE:
TRAINING (attach copies of certificates)
DATE COMPLETED
EXPERIENCE
# OF YRS.
FAST Training
Supervisor/Lead Worker
FEMA IS - 100b and IS - 700a
Experience In Leading Meetings
Other _________________________________
Red Cross Shelter Fundamentals
Red Cross Serving People With Disabilities
Other _________________________________
(recommended)
Describe your professional experience and related personal experience that qualifies you to be a FAST Leader (you may
include any information about current licenses that are related to your present position).
Describe your emergency response experience.
If you have any disabilities, special dietary needs, allergies or medical conditions which require accommodation during
your attendance, please indicate below.
Applicant: I have read the FAQs on the
FAST website ( )
SIGNATURE
Applicant’s Supervisor: I have reviewed the FAST program FAQs and discussed the program with the applicant. I understand and
support the applicant’s commitments for FAST training and deployment.
I recommend this applicant for the FAST leader position.
PRINTED NAME
SIGNATURE
Some accommodations require notification up to 2 weeks prior to the training
to make the necessary arrangements.
GEN 1389 (3/16)
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