CONNECTICUT FAIR PLAN*
CONNECTICUT FAIR PLAN*
ANTI-ARSON COMMITTEE
P. O. BOX 280200
EAST HARTFORD, CT 06128-0200
SCHOLARSHIP FUND
BACKGROUND: The FAIR Plan Anti-Arson Committee has established a
scholarship fund from which stipends will be awarded in
amounts up to $250, in any calendar year per individual.
The Committee reserves the right to exceed that amount
in exceptional cases.
PURPOSE: The scholarship program is designed to subsidize fire
investigators, fire safety professionals, police and
prosecutors who would not otherwise be able to meet the
costs of attending courses or seminars relating to the
prevention, investigation or prosecution of arson fires.
ELIGIBILITY: Candidates must be employed by, or be certified volunteers
serving in state or local fire marshal offices, fire or police
departments or state judicial districts.
CRITERIA: Courses or seminars relating to fire prevention, fire investigation
or the prosecution of arson must be offered by an accredited
educational institution, professional organization or deemed
otherwise acceptable as credit towards the State of Connecticut
requirement of 90 hours in-service training to maintain Bureau of
State Fire Marshal Certification.
PROCEDURE: Submit completed application and descriptive course information
to:
Connecticut FAIR Plan, Anti-Arson Committee, P. O. Box 280200,
East Hartford, CT 06128-0200
Representing the Insurance Industry
CONNECTICUT FAIR PLAN
ANTI-ARSON COMMITTEE
SEMINAR STIPEND APPLICATION
(Please Print or Type)
NAME: ____________________________________________________________________
ADDRESS: _________________________________________________________________
TELEPHONE (H):______________ (W): ____________ SOC.SEC.NO.:_________________
HIGHEST FORMAL EDUCATION: HIGH SCHOOL: _____ COLLEGE: ____ DEGREE: _____
CERTIFIED__________________________________________________________________
EMPLOYER: _____________________________________________ # OF YRS:__________
ADDRESS: ______________________________________________________________
(___) FIRE DEPARTMENT (___) FIRE MARSHAL (___) FIRE INVESTIGATOR
(___) STATE FIRE MARSHAL (___) PROSECUTOR (___) OTHER: ______________
PRESENT POSITION:___________________________________ # OF YRS:_________
SEMINAR YOU PLAN TO ATTEND: _____________________________________________
LOCATION: _____________________________________________________________
DATE: ________ REGISTRATION FEE: _______ AMOUNT REQUESTED: __________
DO YOU HAVE APPROVAL OF YOUR SUPERVISOR, DEPARTMENT, OR AGENCY
TO ATTEND THE SEMINAR? (___) YES (___) NO
APPLICANT MUST ENROLL OR PLAN TO ATTEND AN ACCREDITED SEMINAR OR COURSES IN FIRE PREVENTION, FIRE AND ARSON INVESTIGATION, AND RELATED SUBJECTS.
PLEASE ATTACH A SEMINAR BROCHURE, FLYER, OR A BRIEF DESCRIPTION WITH THIS APPLICATION.
_____________________________________ ____________________________________
SIGNATURE OF APPLICANT SIGNATURE OF SUPERVISOR
RETURN APPLICATION TO: CONNECTICUT FAIR PLAN
ANTI-ARSON COMMITTEE
P. O. BOX 280200
EAST HARTFORD, CT 06128-0978
COMMITTEE ACTION: (__) DISAPPROVED (__) APPROVED AMOUNT_________________
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