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New Mexico State Firefighters
Association
93rd Annual Conference
HOSTED BY
LINCOLN COUNTY FIRE AND EMERGENCY SERVICES
8 June Thru 10 June 2017
FUNTRACKERS BONITO LAKE
SMOKEY BEAR
MUSEUM
FREE TRAINING FIRE FIGHTER’S SKILL CONTEST
ANNUAL ASSOCIATION MEETING
FOR ADDITIONAL INFORMATION
GO TO OUR WEBSITE NMSFFA.NM.ORG
OR CONTACT
LOCATION
BONITA -PARK
NAZARENE CHURCH CAMP
Don Armijo
Rudy Sales
Becky Rodriguez
Ronnie Walls
Spencer Baldwin
Danny Mena
575-740-1060
575-308-9974 575-740-2346
575-441-3276
575-937-2824
505-440-8136
BILLY THE KID
INN OF THE MOUNTAIN
GODS
ALTO LAKE
New Mexico State Firefighters
Association
93rd Annual Conference
Fire Department:
Department Mailing Address:
Zip Code:
Firefighter’s Name:
Spouse’s Name:
Is spouse a firefighter:
Child 1:
Your E-Mail Address:
Your Department E-Mail Address:
Child 3:
Child 2:
With the proper payment by check, money order or purchase order, submitted with this registration form. If you require additional information contact Becky Rodriguez (575) 740-2346.
Please use one form per single firefighter or family and return to:
HOSTED BY
LINCOLN COUNTY FIRE AND EMERGENCY SERVICE
8 June thru 10 June 2017
Registration Fees:
Male & Female Firefighters (Early Bird) (T-Shirt Included): Male & Female Firefighters (Late Registration) (No Shirt Included) : Spouse or Guest of Firefighters (non-firefighters) (No Shirt Included): State Auxiliary Members (No Shirt Included): Children of Firefighters or their guests (under 18) (No Shirt Included):
Phone:
Age :
Age:
Age :
Training Class
Choose One
QTY AMOUNT
$125.00 x _____ = __________
$135.00 x _____ = __________
$60.00 x _____ = __________
$60.00 x _____ = __________
$20.00 x _____ = __________
TOTALS _____ __________
1.
Lifetime Member Yes No
EARLY BIRD REGISTRATION
Registration received or postmarked on or before May 19, 2017: $125.00 – Includes Conference T-Shirt
Registration received or postmarked on or after May 20, 2017: $135.00 – WILL NOT Include T-Shirt
New Mexico State Firefighter’s Association
Attn: Annual Fire Conference
P. O. Box 286 Truth or Consequences, New Mexico 87901
2.
3
4.
5.
7.
6.
9.
8.
10.
4 meals are included in the cost of your registration. Please indicate which meals you will attend:
Lunch
Friday Saturday
Awards Banquet
Lunch
Dinner
New Mexico State
Firefighters Association
93rd Annual Conference
2017 Conference Shirt Order Form
If you do not pre-order a Conference shirt with your pre-registration, you can still order one during registration at the Conference however, you will
not received it until it is shipped to you after the Conference. There will also be an additional fee of $10.00 for shipping.
Indicate the size and quantity of shirt that you need on this form below.
Remember, a firefighter who pays the $125.00 registration fee by
May 19, 2017 will receive their shirt free with their registration package at the registration table at Conference.
If you want/need additional Conference shirts, please indicate the size and quantity below and submit the necessary payment with this form and your
registration.
SIZES QUANTITY PRICE TOTAL AMOUNT
SMALL $15.00
MEDIUM $15.00
LARGE $15.00
XTRA LARGE $15.00
XXTRA LARGE $17.00
XXXTRA LARGE $18.00
XXXXTRA LARGE $19.00
SHIPPING
GRAND TOTAL
YOUTH SMALL $15.00
YOUTH MEDIUM $15.00
YOUTH LARGE $15.00
PLEASE REMIT THIS TOTAL ALONG WITH YOUR REGISTRATION
If you have any questions, contact Jackie or Ronnie Walls at (575) 441-3276
NAME: _____________________________________ TELEPHONE NUMBER: ____________________
New Mexico State Firefighters
Association
93rd Annual Conference
HOSTED BY
LINCOLN COUNTY FIRE AND EMERGENCY SERVICES
8 June Thru 10 June 2017
REGISTRATION LOCATION
BONITA -PARK
NAZARENE CHURCH CAMP
200 BONITA PARK ROAD
CAPITAN, NM 88316
Located at Mile Marker 13 on Highway 48
The Intersection of Highway 37 and Highway 48
Wednesday 13:00 TO 18:00
Thurday 8:00 TO 18:00
Friday 7:00 TO 9:00
San Antonio 380
I 25
Truth Or Consequences
Albuquerque
Carrizozo Capitan
48
Nogal 37
Bonita Park Nazarene Church Camp
200 Bonita Park Road Capitan, NM 88316 Located at Mile Marker 13 Highway 48
The Intersection of Highway 37 and Highway 48
Roswell 285
Artesia 285
Vaughn 285
Clovis 70
Ruidoso Downs 70
Ruidoso 48
Alamogordo 70
MAP
1. Landing Zone’s
THURSDAY
2. Wildland Refresher
3. AMTRAK Passenger Train
Emergency Response
TIMES
10:00—1200
13:30—1700
13:30—16:00
FRIDAY TIMES
5. FF Survival 13:30—1700
6. Fire Service Leadership
7. Fire Hydrants
4. Vehicle Extrication 13:30—1700
13:30—1700
13:30—1500
LOCATION
OES Classroom/Bonito Fire Station
Church Classroom
OES Classroom/Bonito Fire Station
Church Classroom
LOCATION
OES Classroom/Bonito Fire Station
Church Classroom
Church Classroom
NEW MEXICO STATE FIREFIGHTERS ASSOCIATION COURSE SCHEDULE
SATURDAY
Team Captain Meeting
Firefighter Skills
13:30—1400
TIMES
1400—1700
LOCATION
Church Parking Lot
Church Parking Lot
NOTE:
IF YOUR TAKING CLASS 4 VEHICLE EXTICATION OR CLASS 5 FF SURVIVAL
YOU WILL NEED YOUR BUNKER GEAR
Christina Gauthier will be here from PERA on Friday to Answer any questions. She will also
Have a hands on “How to check your Records.”
New Mexico Fallen Firefighters Information Request Form
Please fill out complete and E-Mail to [email protected]
This info will be used to honor our fallen heroes at our Annual Conference, as well as a
Listing on our webpage under “Memorial” NMSFFA.NM.ORG
NAME:;
RANK:
GENDER:
STATUS:
AGE: YEARS OF SERVICE:
DATE OF DEATH:
FIRE DEPARTMENT NAME:
FIRE DEPARTMENT ADDRESS:
FIRE DEPARTMENT PHONE:
FIRE DEPARTMENT CHIEF:
CAUSE OF DEATH:
ADDITIONAL INFO OR COMMENTS:
Conference Evaluation Form
Scoring: Each question will be rated 1-5
5: Strongly 4: Agree 3: Undecided 2: Disagree 1: Strongly Disagree
L The training met my expectation.
2. I will be able to apply the knowledge learned.
3. The training objectives for each topic wereidentified and followed.
4. The content was organized and easy to follow.
5. The materials distributed were pertinent anduseful.
6. The trainer was knowledgeable.
7. The quality of instruction was good
8. The trainer met the training objectives.
9. Class participation and interaction wereencouraged.
10. Adequate time was provided for questionsand discussion
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How can we improve this class? Comments:
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Date: Name of Instructor:
