Florida Department of Agriculture and Consumer Services

Florida Forest Service

FFCA IQS DATA COLLECTION/DATA ENTRY FORM

INITIAL ENTRY FOR AN INDIVIDUAL

1. Person/Org Information

Person ID / Last Name / First Name / Middle Initial / Job Title / Employment Status
EFF

State-NWCG

/

FLFLS

/ Work Address
Org Level 1 / DOACS / City, State, Zip
Org Level 2 / FFS / Mailing Address
Org Level 3 (Unit ID) / City, State, Zip
Org Level 4 (Coop ID) / E-mail Address
Fax # / PrimaryJetPort
Work # / SecondaryJetPort
Home #
Cell # / (Availability - / entered on an as needed basis)
Pager #
Date of Birth / Blood Type / Emergency Contact Info
Sex ( M / F ) / Allergies
Height (Inches) / Medications
Weight (Pounds) / Clothing Sizes

2. Target Positions

Target Position / Risk / Date Created / Priority / Certificates attached (S courses must be NWCG certificates)
SFFT-FFCA / WF / 1 / I-100 S-130 S-190
ENGL-FFCA / WF / 2 / I-200 S- 205 or 215 LEAD FIREFIGHTER ON AN ENGINE
STKL-FFCA / WF / 3 / S-330 COMPANY OFFICER or HIGHER
FFT 2 / WF / 4

FFCA IQS DATA COLLECTION/DATA ENTRY FORM INSTRUCTIONS

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This form is required for all new Incident Qualification Cards applicants.

Un-shaded fields are required.

Section 1 – Person/Org Information

  1. Leave blank.
  2. Employment status shall be (EFF) for Casual/Emergency for all non-Florida Forest Service applicants.
  3. Org Level 3 shall be the District/Center designator (see list below)
  4. Org Level 4 shall be the Cooperator/Fire Department name(located in the State Emergency Response Plan APPENDIX F-Fire Department Designators)

Section 2 – Target Positions

SFFT- FFCA (Firefighter/Engine Operator)

ENGL- FFCA (Engine Leader)

STKL- FFCA (Strike Team Engine Leader)

FFT2 / ENOP- National

After completion on Section 1-3, attached a copy of all certificates of completion for required training and submit to the local Florida Forest Service Forest Area Supervisor or Florida Forest Service Office.

BFC(Escambia, Santa Rosa, Okaloosa)

CFC(Walton, Holmes, Washington, Bay, Gulf, Jackson, Calhoun)

TLC(Gadsden, Liberty, Wakulla, Leon, Jefferson)

D5(Madison, Taylor, Dixie, Lafayette)

SFC(Hamilton, Suwannee, Columbia, Baker, Union, Bradford)

D7(Nassau, Duval, Clay)

WaFC(Gilchrist, Levy, Alachua, Marion, Putnam)

D10(St. Johns, Flagler, Volusia)

WFC(Citrus, Sumter, Lake, Hernando, Pasco

D12(Seminole, Orange, Osceola, Brevard)

D14(Hillsborough, Pinellas, Polk)

D15(Manatee, Hardee, De Soto, Sarasota, Charlotte)

D16(Indian River, Okeechobee, Highlands, Glades, St. Lucie, Martin)

CaFC(Lee, Hendry, Collier)

D18(Palm Beach, Broward, Dade, Monroe)

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