DA Form 5377 Fire and Emergency Services Training Record

DA Form 5377 or the "Fire And Emergency Services Training Record" is a Department of the Army-issued form used by and within the United States Military.

The form - often incorrectly referred to as the DD form 5377 - was last revised on January 1, 2009. Download an up-to-date fillable DA Form 5377 down below in PDF-format or look it up on the Army Publishing Directorate website.

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1. DATE
FIRE AND EMERGENCY SERVICES TRAINING RECORD
For use of this form, see AR 420-1; the proponent agency is ACSIM.
2. NAME, GRADE AND TITLE OF INSTRUCTOR
3. TIME
FINISHED
STARTED
DURATION
4. SUBJECT
5. OBJECTIVE
6. LOCATION OF TRAINING
7. EQUIPMENT AND TRAINING AIDS USED
8. AMOUNT OF AGENTS AND FUEL USED
AGENT
AMOUNT
FUEL
AMOUNT
9. DESCRIPTION OF TRAINING CONDUCTED
10. NUMBER OF PERSONNEL ATTENDED
11. TOTAL MANHOURS
12. REMARKS (Include Days/Interruptions)
13. INSTRUCTOR'S SIGNATURE
14. TRAINING OFFICER'S SIGNATURE
15. OFFICER IN CHARGE SIGNATURE
16. DATA RECORDED ON INDIVIDUAL'S TRAINING RECORD
DATE
NAME, GRADE AND TITLE OF RECORDER
SIGNATURE
DA FORM 5377, JAN 2009
PREVIOUS EDITIONS ARE OBSOLETE
APD LC v1.00ES
1. DATE
FIRE AND EMERGENCY SERVICES TRAINING RECORD
For use of this form, see AR 420-1; the proponent agency is ACSIM.
2. NAME, GRADE AND TITLE OF INSTRUCTOR
3. TIME
FINISHED
STARTED
DURATION
4. SUBJECT
5. OBJECTIVE
6. LOCATION OF TRAINING
7. EQUIPMENT AND TRAINING AIDS USED
8. AMOUNT OF AGENTS AND FUEL USED
AGENT
AMOUNT
FUEL
AMOUNT
9. DESCRIPTION OF TRAINING CONDUCTED
10. NUMBER OF PERSONNEL ATTENDED
11. TOTAL MANHOURS
12. REMARKS (Include Days/Interruptions)
13. INSTRUCTOR'S SIGNATURE
14. TRAINING OFFICER'S SIGNATURE
15. OFFICER IN CHARGE SIGNATURE
16. DATA RECORDED ON INDIVIDUAL'S TRAINING RECORD
DATE
NAME, GRADE AND TITLE OF RECORDER
SIGNATURE
DA FORM 5377, JAN 2009
PREVIOUS EDITIONS ARE OBSOLETE
APD LC v1.00ES
17. PERSONNEL ATTENDING CLASS AND EVALUATION GRADE
EVAL GR*
SIGNATURE OF ATTENDEE
NAME (Last, First, MI)
EVALUATION LEGEND
GRADE
GRADE
1 - FIRE FIGHTER I NFPA 1001
1 - FIRE INSPECTOR I NFPA 1031
2 - FIRE FIGHTER II NFPA 1001
2 - FIRE INSPECTOR II NFPA 1031
3 - FIRE INSPECTOR III NFPA 1031
*Evaluation grade to be recorded on Individual Training Evaluation Record, DA Form 5376
REVERSE OF DA FORM 5377, JAN 2009
APD LC v1.00

Download DA Form 5377 Fire and Emergency Services Training Record

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