VIERA Registration and Consent Form - Pro Board

Consent to Release Information to Pro Board

I hereby consent to allowing Vancouver Island Emergency Response Academy to release the following information to National Board on Fire Service Professional Qualifications - Pro Board for the purpose of being registered with the Pro Board Certification Registry:

Consent to the above statement

Consent to Release Information to Employer

I hereby consent to allowing Vancouver Island Emergency Response Academy to release to my employer my test results, Statement or Certificate of Course Completion and verification of attendance in connection with this course. I understand that my consent is required prior to release of the specified information.

Consent to the above statement

Emergency Contact Information

 

 

Last updated: September 16, 2019

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