FDNY Onsite Exam Request

Instructions
Upon successful completion of the FDNY Computer Based Tests (CBT), Croker can schedule FLSD onsite examinations on behalf of our existing clients.
Number of Candidates Requesting Onsite Exams*
Building Address*
Provide building address where candidate(s) will be taking their FDNY onsite exam.

Street Address City ZIP Code

Candidate's Name*
Candidate's Full Legal Name as appears on Social Security Card
First Last Suffix
Candidate's Nickname (if applicable)
Candidate's Social Security Number (Last Four Digits)*
Candidate's Social Security Number (Last Four Digits)
Please enter a number from 0 to 9999.
Candidate's Phone Number*
Candidate's Email Address
Please provide, if available
Enter Email Confirm Email
Upload FDNY Certificate of Completion (Z-89) or F-89/T-89 Certificate from Another Building (Issued to Candidate)*
FDNY Issued Z-89 Certificate of Completion (Red and White Diploma) --OR-- F-89/T-89 Certificate of Fitness (From Another Building)
Preferred Onsite (Weekday / Weeknight / Weekend)*
- Weekday (Monday-Thursday) (FDNY arrival between 10AM-12PM)
- Weeknight** (Monday-Thursday) (FDNY arrival between 4PM-5PM)
- Weekend** (Saturday) (FDNY arrival between 8AM-10AM)
**NOTE: Weeknight and weekend exams cost an additional FDNY (after-hours) fee. Also, a second staff member shall be present in the building to answer calls from the Fire Command Center (This individual does not need to be certified, however should have sufficient knowledge of the building).
Additional Notes
Include Any Dates That Candidate is Unavailable (i.e.: Vacation) or Preferred Dates of Scheduling (i.e.: Any Monday or Tuesday in January, etc.)

Second Candidate's Name*
Candidate's Full Legal Name as appears on Social Security Card
First Last Suffix
Candidate's Nickname (if applicable)
Candidate's Social Security Number (Last Four Digits)*
Candidate's Social Security Number (Last Four Digits)
Please enter a number from 0000 to 9999.
Candidate's Phone Number*
Candidate's Email Address
Please provide, if available
Enter Email Confirm Email
Upload FDNY Certificate of Completion (Z-89) or F-89/T-89 Certificate from Another Building (Issued to Candidate)*
FDNY Issued Z-89 Certificate of Completion (Red and White Diploma) --OR-- F-89/T-89 Certificate of Fitness (From Another Building)
Drop files here or
Preferred Onsite (Weekday / Weeknight / Weekend)*
- Weekday (Monday-Thursday) (FDNY arrival between 10AM-12PM)
- Weeknight** (Monday-Thursday) (FDNY arrival between 4PM-5PM)
- Weekend** (Saturday) (FDNY arrival between 8AM-10AM)
**NOTE: Weeknight and weekend exams cost an additional FDNY (after-hours) fee. Also, a second staff member shall be present in the building to answer calls from the Fire Command Center (This individual does not need to be certified, however should have sufficient knowledge of the building).
Additional Notes
Include Any Dates That Candidate is Unavailable (i.e.: Vacation) or Preferred Dates of Scheduling (i.e.: Any Monday or Tuesday in January, etc.)

Third Candidate's Name*
Candidate's Full Legal Name as appears on Social Security Card
First Last Suffix
Candidate's Nickname (if applicable)
Candidate's Social Security Number (Last Four Digits)*
Candidate's Social Security Number (Last Four Digits)
Please enter a number from 0000 to 9999.
Candidate's Phone Number*
Candidate's Email Address
Please provide, if available
Enter Email Confirm Email
Upload FDNY Certificate of Completion (Z-89) or F-89/T-89 Certificate from Another Building (Issued to Candidate)*
FDNY Issued Z-89 Certificate of Completion (Red and White Diploma) --OR-- F-89/T-89 Certificate of Fitness (From Another Building)
Drop files here or
Preferred Onsite (Weekday / Weeknight / Weekend)*
- Weekday (Monday-Thursday) (FDNY arrival between 10AM-12PM)
- Weeknight** (Monday-Thursday) (FDNY arrival between 4PM-5PM)
- Weekend** (Saturday) (FDNY arrival between 8AM-10AM)
**NOTE: Weeknight and weekend exams cost an additional FDNY (after-hours) fee. Also, a second staff member shall be present in the building to answer calls from the Fire Command Center (This individual does not need to be certified, however should have sufficient knowledge of the building).
Additional Notes
Include Any Dates That Candidate is Unavailable (i.e.: Vacation) or Preferred Dates of Scheduling (i.e.: Any Monday or Tuesday in January, etc.)

Person Submitting this Request (Contact Information)
Person Submitting this Request (Full Name)*
Person Submitting this Request (Title/Position)*
Person Submitting this Request (Phone Number)*
Person Submitting this Request (Email Address)*
This email address is necessary for Croker, once FDNY confirms/issues an onsite date for the candidate.
Enter Email Confirm Email
Consent*
By checking this box, I authorize Croker to request an FDNY onsite exam for the above referenced candidate.

Instructions