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Rescue 100 Licensure Packet – Applicant (Single Applicant): Please complete this form if you are single. You will need to provide your full name and an email address to sign your completed application online.

Rescue 100 Licensure Packet – Applicant (Married Applicants): Please complete this application if you are married. Both individuals will need to sign the application. Please provide a different email address for each individual. After the first individual signs the completed form, an email will be sent to the second individual requesting a signature for completion of the form.