 
Incident Safety Officer Skills Validation Affidavit |
| Name: ___________________________________ | Last 4 SS#: _______________________________ |
| Agency: __________________________________ | Rank: ____________________________________ |
| Address: _________________________________ | Address 2: _______________________________ |
| City: _____________________________________ | State: _____________ Zip: ________________ |
| Phone: ___________________________________ | Email: ___________________________________ |
| Date of class attendance, if applicable: _____________________________________________________ |
|
Required Skill Sheets |
| Skill sheets can be found at https://www.raft911.org/ISOSheets/ |
| Applicant's Validation Statement |
|
I verify that I have completed the requisite skill sheets provided by RAFT for my INCIDENT SAFETY OFFICER certification. I am only required to return this affidavit, but I understand that RAFT |
| Applicant's Signature: ________________________________________ Date: _______________ |
| Employer Skills Validation Statement (Required) |
I verify that I am a Chief Officer or Supervisor within the above applicant’s agency and that said applicant has
completed requisite skills sheets developed by RAFT as written in NFPA1521-2020 |
edition Standard for Fire Department Safety Officer Professional Qualifications. |
| Print Name: __________________________________________________ Title: ________________ |
|
Signature: ___________________________________________________ Date: _______________
Return a PDF copy of this completed & signed affidavit to our office via email. |