Rad 101

Please read all questions carefully and answer all questions.

First Name *

Last Name *

Date of Birth *

Email *

Phone *

Department/Organization (Please do not use abreviations) *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you an Oklahoma Emergency Responder? *

Are you: *

Are you associated with... *

Do you live more than 60 miles from Edmond? *

Do you require lodging? (You must meet criteria)

Are you willing to share a room with someone from your department/organization?

Are you:

Chief
Training Officer
Only person attending from your department/organization
The only female/male from your department/organization
None of the above - You will be paired with someone in your organization of the same gender

Check in Date (Cannot be before March 10) *

Check out Date (Cannot be after March 14) *

Name of Roommate

First

Last

Class Time	Course Title	Instructor	Location	Course Capacity
8:00am - 10:00am	We Got This! Is Your Department Really Ready?	Bob Coschignano - Hazmat 101 Consultants	Hilton Garden Inn Conference Center
8:00am - 5:00pm	Ethanol Safety	Joel Hendelman	Hilton Garden Inn Conference Center
8:00am - 5:00pm	Curbside Chemist (HOT)	David Raynor	Edmond Fire Training Center
8:00am - 5:00pm	Physical and Chemical Properties (HOT)	Brian Ramsey	Edmond Fire Training Center	25

Wednesday, March 11, 2026 (Please do not choose overlapping classes) *

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