Form FEMA Form 119-25-5 FEMA Form 119-25-5 National Fire Academy Executive Fire Officer Program App

General Admissions Application (Long and Short) and Stipend Forms

119-25-5 EFO Program Application for Admission.REVISED.05082019

Executive Fire Officer program Application for Admission

OMB: 1660-0100

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DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

NATIONAL FIRE ACADEMY
Executive Fire Officer Program
Application for Admission

Dear Applicant:
The National Fire Academy’s Executive Fire Officer Program is an intensive and demanding
two-year cohort program that requires a commitment of both time and energy. The program
includes two on-campus resident sessions. Each year of the program includes intersession work
done through our mediated learning platform. In addition, a comprehensive applied research
paper must also be developed while enrolled in the program.
Due to the limited number of available spaces within the program for each fiscal year, your
application will become part of a competitive selection process whereby our admissions
committee will select the most qualified applicants for the program. Attention to detail is
important. Incomplete application packages will not be advanced or reviewed for consideration.
The information provided on the FEMA Form 119-25-5, along with information provided on the
FEMA Form 119-25-1, will be the basis for selection. Both application forms, 119-25-5 and
119-25-1, must be received no later than close of business on May 15, xxxx. Applications
received after this date will not be considered for the selection process.
We look forward to receiving your application.
Sincerely,

Tonya Hoover
Superintendent
National Fire Academy

Enclosure

Privacy Act Statement
General - This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974), December 31, 1974,
for individuals applying for admission to the National Fire Academy’s Executive Fire Officer (EFO) Program.
Authority - Public Law 93-498, 15 U.S.C. 301.44, U.S.C. 3101, 50 U.S.C. App. 2253, E.O. 12127 and E.O. 12148.
Purposes and Uses - The principal purpose of the information requested on this form is for use in selecting
candidates for the EFO Program.
Effects of Nondisclosure - Personal information provided on this form is given on a voluntary basis, as is
participation in any training program. Failure to provide this information, however, may result in a delay in
processing your application.
Paperwork Burden Disclosure Notice
Public reporting burden for this data collection is estimated to average three hours. The burden estimate includes
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and submitting this form. You are not required to respond to this collection of information unless a valid
OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and
any suggestions for reducing the burden to: Information Collections Management, Department of Homeland
Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork
Reduction Project (1660-0100) NOTE: Do not send your completed form to this address.
Application Instructions
1.

Please type.

2.

Please provide all information requested and be concise in your responses.

3.

Mail the application to:

U.S. Fire Administration/National Fire Academy
National Emergency Training Center
Office of Admissions, Building I-216
16825 South Seton Avenue
Emmitsburg, Maryland 21727

DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

APPLICATION FOR ADMISSION

NATIONAL FIRE ACADEMY
EXECUTIVE FIRE OFFICER PROGRAM

NAME OF APPLICANT

O.M.B. NO. 1660-0100
Expires November 30, 2016

STUDENT IDENTIFICATION (SID) NUMBER

APPLICANT EMAIL
CHIEF’S NAME/EMAIL
SECTION I - GENERAL INFORMATION
Please describe your organization fully in terms of functions or services provided and its annual budget.

Please describe your specific duties and responsibilities within the organization at an executive level. Are you a Company-level officer or Command-level officer on your
department? Are you on a promotional list for a chief-level officer’s position? Daily, how many people do you manage and supervise? Describe your planning and problem-solving
abilities.

FEMA Form 119-25-5, AUG 2010

PREVIOUSLY FEMA Form 95-22

Page 1

SECTION II - BRIEF ESSAY QUESTIONS
Describe your involvement in policy development for your department. Please describe your role within this activity. Are you in charge of a division, bureau, group or major
activity within your agency which involves the coordination of effort, supervising, fiscal oversight, planning and the managing of resources? Describe your problem-solving abilities.

Describe your experience in human resource management and development.

Have you participated with your agency in any activities that involved your community? If so, please provide specifics.

Page 2

SECTION III – Personal Section
Personal Essay Section. Your essay’s contents will be shared with cohort members if accepted into the program and assigned a cohort: (750 words)
1.

State your reasons for attending the EFO Program and what you seek to gain from this experience.

2.

How will this educational opportunity enhance you as an individual, your organization and the community in which you serve?

3.

Your essay should be closed with a one-paragraph statement which describes your own personal leadership philosophy.

Page 3


File Typeapplication/pdf
File TitleNational Fire Academy Executive Fire Officer Program Application Form
SubjectNational Fire Academy Executive Fire Officer Program Application Form is used as a part of the annual application process for th
AuthorUSFA/NFP/PLD
File Modified2019-05-09
File Created2019-04-24

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