Recruit Fire Fighter Information

December 2015

 

 

 

SAANICH FIRE DEPARTMENT 

 

 

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INTRODUCTION  The Saanich Fire Department was established in 1919. Today the Department employs 130.5 personnel, representing Suppression and Rescue, Fire Prevention, Training, Communications, Staff Development, Mechanical and Administration divisions. The Department services an area of 103.4 square kilometres which includes approximately 110,000 people. Saanich’s diverse terrain, with ocean coastline, lakes, forests and mountains makes for a variety of emergency responses. The Department’s mandate is to protect citizens and property; to provide all proper measures to prevent, control and extinguish fires and provide assistance to medical emergencies, land and marine rescue operations, requests from other fire services, hazardous materials incidents and requests for public service. In addition to the delivery of firefighting and rescue services, the Department is responsible for a variety of contract services and programs. Contracts for delivery of Fire dispatch, high angle rescue and mechanical services are in place with a number of neighbouring municipalities as well as participation in the CRD Regional Hazmat Team. Programs delivered by the Department include marine fire rescue, medical first responder, technical rescue, juvenile fire setter Intervention, incident pre-planning, general fire safety and public building inspections. The Saanich Fire Department is also responsible for the administration of the Saanich Emergency Program. The Department’s good standing in the community is attributed to the commitment and dedication of its members and their desire to provide the highest level of public service.

 

 

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FIREFIGHTING AS A CAREER  Firefighting is a skilled position that entails responding to a variety of emergency situations where life, property or the environment is at risk. Today’s fire fighter must be a skilled, competent professional, able to meet every kind of emergency. Under the direction of a Fire Department Officer a fire fighter performs non-emergency routine duties and is involved as a team member responding to a wide range of emergency hazards and stressful conditions. A fire fighter must be able to accept orders without question and work effectively as a team member, although considerable independence of judgment and action may be required in circumstances of extreme urgency where referral to a supervisor for instruction is not possible. Firefighting is an employment opportunity that offers a challenging, demanding, exciting and rewarding career for men and women where ongoing in-service training and education never ends. Illustrative duties and responsibilities in a firefighting career include the following:

Fire suppression Fire prevention Inspections of public buildings and fire hazard conditions Preparing and delivering public fire safety education Medical emergency response Hazardous materials response Safe operation and maintenance of Fire Department apparatus Operation of computers In-station fire hall duties Dispatch Training drills Pre-fire planning Fire investigation Rescue operations – land, marine and technical rope rescue

Applications for employment are advertised on the District of Saanich website and selectively in the Times Colonist newspaper. It is our policy to not accept general applications for employment prior to a recruiting competition. To find out about any current postings visit www.saanich.ca.

 

 

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MINIMUM APPLICATION REQUIREMENTS 

NFPA 1001 Firefighter I and II High school graduation or equivalency Vision: 20/30 visual acuity unaided and uncorrected; colour vision to standards required

by the BC Superintendent of Motor Vehicles as a prerequisite for a BC Driver’s Licence (verified in a full pre-employment medical)

University of Victoria or University of Alberta Fire Fighter Physical Fitness evaluation, must be current dated within six months of application (see attached UVIC Fire Fighter Physical Abilities Test Information)

Pleasure craft operator certification Restricted radio operator’s certificate (Maritime) Hearing test (verified in a full pre-employment medical) Physically fit (verified by testing) Successful completion of aptitude test Driver’s license abstract with not more than six ICBC penalty points within the last three

years Criminal record check dated within three months of competition Valid Class 3 Driver’s Licence with air brake endorsement for the Province of BC or

equivalent endorsement from out of Province At least one of the following: valid Occupational First Aid Level 3, EMA First Responder

Level III, Red Cross First Responder or EMR certificate Demonstrated ability to work in a team environment

DESIRABLE QUALIFICATIONS 

NFPA Fire Service related courses Post-secondary education program (academic, technical or trades training) Class 4 Driver’s Licence Completion of a defensive driving course Ability to swim Scuba diving certification Power Squadron certification Ability to operate a personal computer (minimum 25 wpm) and other communications

equipment Familiar with building construction Experience in the operation of heavy equipment. Volunteer community work Public speaking ability

 

 

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RECRUITMENT AND SELECTION PROCEDURE  The recruitment process consists of 8 stages: STAGE 1 Application STAGE 2 Aptitude Test STAGE 3 Agility and Dexterity Evaluation STAGE 4 Ride-A-Long Program STAGE 5 Screening and Personal Interview STAGE 6 Reference Check STAGE 7 Selection for Eligibility Pool STAGE 8 Medical Examination Employment Offer Applicants must pass through ALL eight stages of the process. Those who fail to meet the required standard at any stage will not be permitted to proceed to the next stage in the selection process. Candidates may also be disqualified if they do not meet deadlines.

1. The Saanich Fire Department reserves the right to limit the number of candidates who will proceed to the next stage.

2. Candidates with the minimum qualifications do not automatically proceed to the next

stage.

3. All applicants will be notified during the process if they will be moving on to the next stage via email. It is the candidate’s responsibly to ensure email addresses are valid and up to date.

4. All testing stages are in person and cannot be faxed, emailed or taken online.

 

 

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DESCRIPTION OF STAGES  STAGE 1 APPLICATION Applications will be accepted from the advertised/posted opening date until 4:30 p.m. of the closing date. The following documentation MUST be submitted WITH the application:

Saanich Fire Department completed application form Photocopies of all relevant licences and certificates:

o Proof of NFPA 1001 Firefighter I and II certification o At least one of: a valid Occupational First Aid Level 3, EMA First Responder Level III,

Red Cross First Responder or EMR certificate o Class 3 Driver’s Licence with Air Brake endorsement o Driver’s Licence abstract with not more than six (ICBC) penalty points within the last

three years and dated within three months of the competition o Proof of Pleasure Craft Operator Certification o Proof of Restricted Radio Operator’s Certification (Maritime) o Proof of High School graduation. This must be a Provincial Board of Education

Diploma, a high school transcript which clearly states that required credits were achieved for graduation, or a High School Equivalency certificate

o Certificates for all Fire Service related courses A full and complete Criminal Record Check from the Police Department serving the area

the candidate resides in dated within three months of the posted date of the competition or a receipt showing that one has been requested.

Copy of the University of Victoria or Alberta Fire Fighter Physical Abilities Test must be current dated within six months of application (see attached information from UVIC).

Applicants are responsible for providing all information regarding their qualifications and experience. A resume attached to your application is recommended. All applications must be submitted to: Fire Administration 760 Vernon Avenue Victoria, B.C. V8X 2W6 Between 8:30-4:30 p.m., Monday through Friday. We appreciate all applications, but only those applicants under consideration will be contacted.

 

 

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STAGE 2 APTITUDE TEST The test is a written exam to determine:

Knowledge of basic mathematics Problem solving, reasoning and decision making Spatial scanning Reading comprehension Mechanical reasoning.

The exam consists of multiple choice questions and must be completed within the designated time limit. Your valid Driver’s Licence will be required for identification. Only those candidates deemed to be eligible to proceed to the next stage of the process will be notified by email. STAGE 3 AGILITY AND DEXTERITY EVALUATION This evaluation may include, but not limited to, the following;

Aerial ladder climb Stair climb with equipment Make and break hose Ladder raise Search with blacked out mask Equipment carry

Evaluation tests for aerobic fitness, upper body strength, lower body strength and fine motor skills related to job requirements.

STAGE 4 RIDE-A-LONG PROGRAM The Ride-A-Long Program is completed over a two day period. It consists of reporting to a fire station and being exposed to firefighting duties:

Fire station duties Training with the fire crews Attending emergency calls with fire station crews; your involvement will be at the officer’s

discretion Participants will be observed and evaluated by the on-duty fire crews

 

 

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STAGE 5 SCREENING AND PERSONAL INTERVIEWS Short-listed candidates are invited to attend a pre-screening interview. Interviews are scheduled during regular business hours and are conducted by the Fire Chief, Deputy Chief of Administration, Deputy Chief of Operations, Staff Development Officer, and a representative from the Fire Fighters Union Local 967 (IAFF). Following the interview, candidates will complete a behavioural assessment. STAGE 6 REFERENCE CHECK Each candidate will be required to submit not less than three references from current or previous employers. Candidates may also submit personal references in support of their application; however, they will not be accepted in place of current or previous employment references. All references will be checked. STAGE 7 SELECTION FOR ELIGIBILITY POOL Following completion of all prior stages the interview/selection panel will meet to review test results. A hiring eligibility pool will be established concurrent with the future needs of the Department. Placement in this pool does not guarantee employment. NOTE: The Saanich Fire Department reserves the right to terminate the hiring eligibility pool and

commence a new recruit competition at any time. STAGE 8 MEDICAL EXAMINATION This comprehensive medical examination is in accordance with NFPA 1582 Chapter 6 – Medical Evaluation of Candidates. This examination also includes vision and hearing testing. A complete copy of the NFPA 1582 Standard may be purchased from the National Fire Protection Association (www.nfpa.org). Alternately, a copy may be viewed at the Fire Administration office at 760 Vernon Avenue, between 8:30-4:30 pm, Monday-Friday. Condition of employment is subject to all NFPA 1582 Medical Examination standards being met. Scheduling details for examination will take place immediately prior to Employment Offer. The cost of this medical examination is the responsibility of the applicant. EMPLOYMENT OFFER Offers of employment may be made to applicants selected in Stage 8 when a vacancy becomes available.  

Exercise Physiology Laboratory School of Exercise Science, Physical & Health Education

University of Victoria

~ University of Victoria Firefighter Physical Abilities Test ~ Appointment Checklist

This information package provides a detailed overview of the physical evaluation process.

You can book your appointment on our online booking system at www.firetest.ca. Spaces are extremely limited due to facility availability, so the sooner you book, the more options you have. There are not currently any additional times to book other than what is listed on the website.

You must confirm your appointment by sending in Page 9 of the Information Package AND a cheque or money order payable to University of Victoria for $250.00. Your appointment is pending until your payment is received. We reserve the right to offer your testing time to another candidate without notice if your payment is not received within the required timeframe. When your payment is received in full, you will receive a confirmation email. NSF cheques are subject to an additional fee of $25 and your appointment will be cancelled or your results will not be disclosed to yourself or the fire department until payment is made in full.

Complete the Checklist!

To do

Action Done

• Book your appointment • Visit www.firetest.ca • Complete page 9 and attach

payment of $250 (payable to University of Victoria)

• Mail to University to arrive 14 days before your appointment

• Arrange doctor’s

appointment to complete medical clearance form (page 10-11)

• Bring the completed Medical Clearance Form with your on your test day (PLEASE DO NOT MAIL IN WITH YOUR PAYMENT)

• Read the Information

Package carefully • Prepare as well as you can

• Questions? Problems? • Email us for help

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School of Exercise Science, Physical & Health Education University of Victoria

~ University of Victoria Firefighter Physical Abilities Test ~

Information Package

The physical evaluation program is administered by the School of Exercise Science, Physical & Health Education at the University of Victoria. Please read the following information carefully in order to prepare for the tests. GENERAL INFORMATION The tests will be completed at the University of Victoria in Victoria, British Columbia. Schedule yourself to attend a testing time that corresponds to the currently available test times and dates. All current available dates and times are listed at www.firetest.ca A copy of your personal results will be given to you as soon as you finish the tests, and when appropriate, a copy will be forwarded to the fire department or training centre with active competitions. The testing program runs on a strict schedule, so you must be on time. If you are not familiar with the University of Victoria campus, please allow yourself a little extra time to acquaint yourself with the area. You should expect to be at the University for approximately 3 hours on your test day. This amount of time permits adequate rest between tests so that you will be able to perform as well as possible. NEW!!! TESTING LOCATION The tests are conducted in the McKinnon Building at the University of Victoria. This complex is located off of McKenzie Avenue on Gabriola Road (see the enclosed campus map on page 8 or http://www.uvic.ca/search/browse/maps.php). Pay parking is required on most days and times, but check the dispensers upon arrival to determine whether or not this is applicable during your test time. Upon arrival to the McKinnon Building, proceed to Room 166 to check-in for your test. There are male and female locker rooms available where you may change and shower. You should bring your own towel and a lock with you to put on a "day-use" locker, since we have no provision for securing your valuables.

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COST OF TESTING The fee for the testing service is $250 (including taxes). This fee is non-refundable and must be paid in full to confirm your appointment.

• You must pay by cheque or money order payable to the University of Victoria.

• NSF cheques are subject to a $25 fee and will result in cancellation of your appointment and/or your results being held from yourself or the fire department to which you are applying.

• No refunds will be given for missed or cancelled appointments without a medical reason and accompanying medical documentation.

Credit card payments cannot be accepted at this time. CONFIRMING YOUR APPOINTMENT You will receive an email acknowledging your pending appointment date and time after booking at www.firetest.ca. Note that your appointment is not confirmed until your test has been paid for in full. You must confirm your appointment by mailing the Appointment Confirmation Form (page 9 of this package) to the University of Victoria at the following address: Melissa Clarke School of Exercise Science, Physical & Health Education University of Victoria PO Box 1700 STN CSC Victoria, BC V8W 2Y2 You must include the $250 non-refundable fee to secure your test appointment and should be received at the University at least 14 days before your test day. We reserve the right to offer your testing time to another candidate without notice if your payment is not received within the required timeframe. MEDICAL CLEARANCE FOR TESTING The tests are very demanding and are designed to assess the physical capabilities of healthy individuals. In order to be tested, you must have a physician certify that you are medically fit to undertake the tests. The Medical Clearance for Testing form (pages 10 and 11 of this package) must be signed by your physician and you must bring it with you when you come to the University for testing. You will not be permitted to complete the tests unless this form has been completed by your physician.

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DESCRIPTION OF THE PHYSICAL FITNESS TESTS This program is designed to evaluate the physical work capacities of healthy, physically active individuals. Each test requires a maximal effort. All of the tests are completed while wearing firefighting personal protective equipment (PPE) that weighs approximately 22 kg (50 lb). This ensemble includes: helmet, flash-hood, gloves, pants, boots, jacket and self-contained breathing apparatus (SCBA). You will not breathe from the SCBA, but you must carry it. If you have your own PPE, you are encouraged to bring it to complete your test. For safety during the treadmill test, running shoes are substituted for firefighting boots. After completing the treadmill test, you will rest for 60 minutes before starting an orientation to the job-related performance tests. The orientation to the job-related tests consists of a “walk-through” session to practice each of the tasks. This will take approximately 30 minutes and will familiarize you with testing procedures and provides a suitable warm-up for the demanding tests that follow. Each test is followed by a rest period of 3 minutes for recovery and hydration. You are not permitted to leave the testing area or remove any parts of the PPE during the rest periods. The tests are described briefly in the following sections: 1. Aerobic Endurance Aerobic fitness will be predicted during a progressive exercise test to exhaustion on a treadmill. After a standardized 5-minute warm-up using an increasing incline, you will walk at 3.5 mph and 10% grade for 8 minutes. If you can continue to exercise, the grade (and if necessary, speed) will be increased every minute until you reach exhaustion. Depending on your fitness level and motivation, this test may last up to about 20 minutes. In order to pass the aerobic fitness standard, you must complete the 5-minute warm-up and the 8-minute stage at 3.5 mph and 10% grade (13-minutes total). 2. Charged Hose Advance Test You will drag a charged (full of water) 38 mm (1.5 inch) hose a distance of 45 m (125’). Three 15 m (50') lengths of hose are "snaked" behind the starting line. The nozzle is held over the shoulder and you advance to the finish line as quickly as possible (running is not permitted). This test assesses lower body strength and power and must be completed safely in less than 32 sec.

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3. High Volume Hose Pull Test You will pull a bundle of hose weighing approximately 56 kg (123 lb) a distance of 15 m (50’) over a smooth concrete floor using a rope. This task is repeated 3 times. During this test, you must stand still and pull the hose bundle towards you using 16 mm (5/8") rope. This test assesses upper body strength, power, and endurance and must be completed safely in less than 102 sec.

4. Forcible Entry Simulation Test You will use a 3.6 kg (8 lb) "dead blow" sledge hammer to move a weighted truck tire (102 kg or 225 lb) a distance of 30.5 cm (12”) as rapidly as possible. This test assesses muscle strength, power and endurance, particularly in the upper body and must be completed safely in less than 45 sec. 5. Victim Drag Test You will drag a mannequin weighing 68.2 kg (150 lb) a total distance of 30 m (100'). The test starts with the mannequin lying "face-up" on the floor. You will lift the mannequin and walk backwards for 15 m, turn around a traffic cone and return to the start line as quickly as possible. This test assesses muscle strength and endurance and must be completed safely in less than 49 sec. 6. Ladder Climb Test You will climb a 7.3 m (24’) ladder to the 10th rung and return to the floor as quickly as possible. This task will be repeated five times. This test assesses muscle strength, endurance, and anaerobic capacity and must be completed safely in less than 108 sec.

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7. Equipment Carry/Vehicle Extrication Test You will carry small (18 kg or 40 lb) and large (36 kg or 80 lb) vehicle extrication tools (the “Jaws of Life”) a total distance of 30 m (100’). In addition, you will lift and hold the 18 kg tool in specific positions that simulate the work required to remove a vehicle door. This test is designed to evaluate the strength and endurance required to lift, carry and use heavy tools in rescue situations. This test must be completed safely in less than 270 sec. EFFECTIVE PREPARATION FOR THE TESTS In order to do your best, you should come to the laboratory on your testing day well nourished and well rested. You should not do strenuous exercise on the days immediately before your tests. Sleep well the night before and try to be as relaxed as possible. Avoid alcoholic beverages the day before and definitely on the day of your test. Do not smoke or drink beverages with caffeine (tea, coffee, hot chocolate, cola, energy drinks, etc.) for at least two hours prior to your test. Excessive caffeine consumption can significantly increase your heart rate and blood pressure, and if elevated beyond normal values, may prohibit you from completing the test at your booked time. Do not eat for at least two hours before your test appointment. However, it is important to be well nourished and well hydrated. The tests are very demanding and most individuals are extremely tired at the end of each test. If your appointment is first thing in the morning, do not skip breakfast. You should eat a light meal (e.g., fruit, toast or cereal, and juice) about three hours before your test. WHAT DO I NEED TO BRING? Clothing Bring the following items of clothing with you: shorts, two T-shirts, running shoes, extra socks, and sweats. Your T-shirt will be wet from sweat after the treadmill test. You should change into a dry shirt and then put on sweats to keep warm during the 60-minute rest period. If you have your own turnout gear, it is recommended that you bring it so that you have a set that is your size. We have a number of pieces of gear in standard sizes that have been handed down from various departments, but cannot guarantee your size will be available at the time of your test. Please note that the only article you may not be able to wear from your own equipment is your boots. To standardize the test so it is fair for

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all applicants, everyone must wear the same type of boots. We have the older style rubber boots available. If you have your own rubber boots, feel free to bring them and we will inspect them at the time of your test to determine whether or not they are acceptable. We have a good selection of sizes; however getting an exact fit may not always be possible. In order to get the best fit, bring several pairs of socks (thin and thick sport socks). Nutrition You should bring a water bottle or sports drink (e.g., Gatorade). You may want to eat a small snack (e.g., banana or energy bar) during the rest period between the treadmill test and the job-related tests. Be careful to practice in advance so that you know how much to eat and drink during 3+ hours of intermittent, extremely strenuous exercise. If you eat or drink too much you may feel sick and do poorly. If you eat and drink too little, you may get dehydrated and do poorly. Optimal nutrition and hydration strategies tend to vary between individuals. Work this out for yourself. Don’t follow someone else’s advice unless you have had the chance to make sure it works for you under the kind of conditions you will experience during these tests. Identification Government issued photo ID is required in order to register for the test and verify your identity on test day. Medical Clearance You must bring the Medical Clearance for Testing document that has been completed by your physician. This document provides medical clearance for you to undertake the specific tests in this program. You will not be permitted to do any of the tests until the Medical Clearance for Testing document has been signed by your physician. Please do not mail the paperwork in with your payment; bring the medical clearance with you on your test day.

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UNIVERSITY OF VICTORIA – CAMPUS MAP http://www.uvic.ca/search/browse/maps.php

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~ University of Victoria Firefighter Physical Abilities Test ~ Confirmation of Appointment

WHEN YOU RECEIVE YOUR APPOINTMENT TIME, COMPLETE THE FOLLOWING INFORMATION AND MAIL TO: Melissa Clarke School of Exercise Science, Physical & Health Education University of Victoria PO Box 1700 STN CSC Victoria, BC V8W 2Y2 Cheques and money orders should be made payable to the UNIVERSITY OF VICTORIA. Name: _____________________________________________________ Address: ________________________________________________ (Street Address) ________________________________________________ (City) (Province) (Postal Code) Telephone: ________________________________________________ E-mail: ________________________________________________ I will attend the Firefighter Physical Fitness Evaluation at the following time: Date __________________________ Time_________________ If you have questions about your appointment, email firetest@uvic.ca or visit www.firetest.ca. Enclose a CHEQUE OR MONEY ORDER (payable to the University of Victoria). Full payment is required to confirm your appointment. This page and your payment must be received 14 days BEFORE your appointment.

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School of Exercise Science, Physical & Health Education University of Victoria

~ University of Victoria Firefighter Physical Abilities Test ~

Medical Clearance for Testing

Applicant name______________________________________________ This program is designed to evaluate the physical work capacities of healthy, physically active individuals. Each test requires a maximal effort. All of the tests are completed while wearing firefighting personal protective equipment (PPE) that weighs approximately 22 kg (50 lb). This ensemble includes: helmet, flash-hood, gloves, pants, boots, jacket, and self-contained breathing apparatus (SCBA). The applicant is not required to breathe from the SCBA, but must carry it. For safety during the treadmill test, running shoes are substituted for firefighting boots. The tests are administered by the School of Exercise Science, Physical & Health Education at the University of Victoria, and are not medically supervised. The test procedures are described briefly below: Aerobic Endurance Maximum oxygen uptake (VO2max) will be predicted during a progressive, incremental exercise test to exhaustion on a treadmill. During the test heart rate is monitored continuously with a telemetry system. Depending on fitness level and motivation, this test normally requires the individual to walk on the treadmill for between 10 – 20 minutes. Regardless of the fitness level of the individual, the test normally involves a maximal effort and is terminated when the person is too fatigued to continue exercise. Combined with the exercise stress, the weight and heat retention properties of the PPE result in a significant level of fatigue. After completing the treadmill test, the applicant will rest for 60 minutes before moving on to the job-related performance tests. JOB-RELATED PERFORMANCE TESTS Prior to completing the job-related tests, the applicant will complete a “walk-through” session where they are allowed to practice each of the tasks. This takes approximately 30 minutes and serves to familiarize the applicant with testing procedures and provides a suitable warm-up for the demanding tests that follow. Each test is followed by a rest period of 3 minutes for recovery and hydration. Applicants are not permitted to leave the testing area or remove the PPE during the rest periods. Charged Hose Advance Test Applicants drag a charged (full of water) 38 mm (1.5 inch) hose a distance of 45 m (125’). Three 15 m (50') lengths of hose are "snaked" behind the starting line. The nozzle is held over the shoulder and applicant advances to the finish line as quickly as possible. This test assesses lower body strength and anaerobic power.

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High Volume Hose Pull Test Applicants pull a bundle of hose weighing approximately 56 kg (123 lb) a distance of 15 m (50’) over a smooth concrete floor using a rope. This task is repeated 3 times. During this test, the applicant is stationary and must pull the hose bundle towards them using 16 mm (5/8") rope. This test assesses upper body strength, power, and endurance. Forcible Entry Simulation Test Using a 3.6 kg (8 lb) "dead blow" sledge hammer, the applicant moves a weighted truck tire (102 kg or 200 lb) a distance of 30.5 cm (12”) as rapidly as possible. This test assesses muscle strength, power and endurance, particularly in the upper body. Victim Drag Test The applicant drags a mannequin weighing 68.2 kg (150 lb) a total distance of 30 m (100'). The test starts with the mannequin lying "face-up" on the floor and the applicant standing. The applicant lifts the mannequin and walks backwards for 15 m, turns around a traffic cone and returns to the start line as quickly as possible. This test assesses strength, power, and agility. Ladder Climb Test The applicant climbs a 7.3 m (24’) ladder to the 10th rung and returns to the floor as quickly as possible. This task will be repeated five times. This test assesses muscle strength, endurance, and anaerobic capacity. Equipment Carry/Vehicle Extrication Test The applicant carries small (18 kg or 40 lb) and large (36 kg or 80 lb) vehicle extrication tools (the “Jaws of Life”) a total distance of 30 m (100’). In addition, the applicant will lift and hold the 18 kg tool in specific positions that simulate the work required to remove a vehicle door. The tools will then be returned to the storage cabinet. This test is designed to evaluate the strength required to lift, carry and use heavy tools in rescue situations. Is this individual taking any medication that could affect normal physiological responses to exercise? No______ Yes_______ If yes, please explain. Resting heart rate: ______________ bpm Resting BP: ______________ mmHg If heart rate is greater than 100 bpm and/or blood pressure is greater than 144/94 mmHg, is this individual in sufficient health to undertake maximal exercise? No ______ Yes______ If yes, please explain. Is there any medical reason that this individual should not undertake maximal exercise? No ______ Yes______ If yes, please explain. I certify that this applicant has been given a medical examination and is medically fit to undertake the Physical Fitness Evaluation described above. Physician's Name_________________________________Date_____________ Address_________________________________________________________ ___________________________________Telephone_______________ Signature____________________________________