Name:    ___________________________________________________________________________

Street Address:  ________________________________________________  Apt.  ________________

City:  ____________________________         State:  ____________              Zip:  ___________

Phone:  _____________________________       Cell Phone:  __________________________________

Fax / Other :  ___________________________            E-Mail:  _____________________________________

Date For Rental:  ____________    Date / Time for Pickup: _____________    Returned:  ____________

Rental Includes:		Medium	Large	XL	XXL	XXXL
Helmet / Face Shield
Nomex Hood (you keep after classes)
Bunker Coat
Bunker Pants
Fire Fighter Boots	Size:
Total Rental:	$450.00 *
Deposit:	$100.00 ***
Boot only rental - $45 + $50 Deposit	$95.00**
Helmet only rental - $45 + $50 Deposit	$95.00**
Boot & Helmet rental - $90 + $100 Deposit	$190.00**
Available For Purchase:
Fire Fighter Gloves	$  42.00
Nomex Hoods	$  32.00
Knee Pads (you will need them!)	$  12.50
6.5% FL Sales Tax on Purchases	$
Total Purchase	$

*     Mini Rental (3 days to 10 Days for Refresher Classes ) - $150.00 with $100.00 refundable deposit. 

**    Boot, helmet or both rental includes refundable deposit of either $50 or $100 as stated above

***  Deposits are refundable – upon return of all equipment to EMERCO

Method of Payment (along with a copy of your Driver’s License):

�  Cash                   �  Check                  �  Money Order

Note:      If you are writing a check, bring one for the gear and one for the deposit. 

When the gear is returned, we will then return the deposit check back to you

	S I Z I N G   C H A R T  -- S E E  A T T A C H E D
Jacket	Jacket	SIZE	Pants	Pants
Chest	Sleeve		Inseam	Waist
36" - 38"	31"	M	29"	26" - 30"
40" - 42"	32"	L	29"	31" - 34"
44" - 46"	33"	XL	30"	35" - 38"
48" - 50"	34"	XXL	31"	39" - 42"
52" - 54"	34'	XXXL	31"	43" - 46"
56" - 58"	35"	XXXXL	31"	47" - 50"
60" - 62"	35"	XXXXL	31"	51" - 54"

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