Refresher Course Request

Use the form below to request your county-specific Refresher Course

NOTE: As a prerequisite, you must have completed the full-length (standard) course within the prior 3 years of this request.

Upon receiving your request we will verify your past participation in our database records and if you qualify to access the Refresher Course, the content will be provided to you using the contact information you provide on this form.

Please contact us if you need assistance or have questions or unique needs, by emailing practicalpipelines@smalleyfnd.org or calling 972-472-6500

Question Title

* 1. Your Contact Information

Name

Title

Agency

Mailing Address

City/Town

State/Province

ZIP/Postal Code

County

Email Address

Phone Number

Question Title

* 2. Have you completed the full-length (standard) course found on your county page of the Practical Pipelines website within the last 4 years?
(If your answer is "no", you will need to complete the full-length video before being eligible to access the refresher course)

Yes

If yes, in what YEAR did you last train with us?

Question Title

* 3. If you were at a different agency last time you trained with Practical Pipelines, please list the information below to help us locate your training record in our system.

Question Title

* 4. Upon confirmation of eligibility, the Refresher Course content can be provided in the following methods. Please select your preference.

Email the content to me using the email I provided above (fastest way to access the training)

Mail the content to me on a DVD using the mailing address that I provided above

Mail the content to me on a USB using the mailing address that I provided above

Question Title

* 5. If you have trained with Practical Pipelines in the past, please list any outstanding questions, concerns, needs or requests you may have. (If none, leave blank)

Question Title

* 1. Your Contact Information

Question Title

* 2. Have you completed the full-length (standard) course found on your county page of the Practical Pipelines website within the last 4 years?(If your answer is "no", you will need to complete the full-length video before being eligible to access the refresher course)

Question Title

* 3. If you were at a different agency last time you trained with Practical Pipelines, please list the information below to help us locate your training record in our system.

Question Title

* 4. Upon confirmation of eligibility, the Refresher Course content can be provided in the following methods. Please select your preference.

Question Title

* 5. If you have trained with Practical Pipelines in the past, please list any outstanding questions, concerns, needs or requests you may have. (If none, leave blank)

* 2. Have you completed the full-length (standard) course found on your county page of the Practical Pipelines website within the last 4 years?
(If your answer is "no", you will need to complete the full-length video before being eligible to access the refresher course)