Future Operations Base Membership Form

Future Operations Base Membership Form
Date*

MonthDayYear
Date
Name of Applicant*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Emergency Contact

For Volunteering Purposes
Emergency Contact’S Name

First NameLast Name
Emergency Contacts Phone Number

Area CodePhone Number
Relationship
Military Membership:

Complete Only if You Served in the Military
Status:

Active DutyRetiredVeteranReserves
In which Military Branch did you serve?
Dates Served
Rank
Type of Separation
Type of Disability and Rating
Are you able to provide a copy of your DD-214?

YesNo
First Responder Membership

Complete Only if You Served as a First Responder
Type of Service

Law EnforcementFire FighterEMSDispatchCorrections
Organization
Title
Division
Status
Time Period Served
Widow/Widower Membership

Complete only if Widow/Widower of Service Member/First Responder
Name of Spouse
Type of Service

MilitaryFirst Responder
Branch/Organization of Spouse
Time Served
Are you able to provide proof of service?

YesNo
Family Membership

Complete if Seeking a Family Membership
Choose One
Name of Family Member
Your Relation to Family Member
If "Other" What is your relation to the Family member?
Current Status of Qualifying Relative
Do you have the ability to prove this relation?

YesNo
How?
Your current occupation:
Name of Company:
F.O.B. Kids Membership

Children younger than 16
Name of Child 1

First NameLast Name
Date of Birth

MonthDayYear
Date
Name of Child 2

First NameLast Name
Date of Birth

MonthDayYear
Date
Name of Child 3

First NameLast Name
Date of Birth

MonthDayYear
Date
Name of Child 4

First NameLast Name
Date of Birth

MonthDayYear
Date
Volunteering Information

Complete if You Would like to Volunteer with F.O.B.
Are you interested in volunteering with Future Operations Base?

YesNo
What Skill-sets do you have and would like to share with F.O.B.

WoodworkingWeldingFabricationTile WorkPlumbingHVACElectricalHome RepairAutomotive RepairSmall Engine RepairComputer SkillsDraftingPaintingManual LaborLandscaping/YardworkGreat ConversationEvent PlanningMember EngagementOther
Are you licensed or professionally trained in any of the skills above? If so which?
Would you like to serve on a committee?

YesInterested
Do you own or work for a company that would like more information about being a F.O.B. Community Partner or Sponsor?

Yes
How did you hear about FOB?
If by word of mouth who told you about us?
All applicants for membership may be required to undergo a Criminal History Check. However, having a criminal history does not automatically preclude you from membership per F.O.B. Bylaws. By clicking submit the applicant agrees to undergo a Criminal History Check, and have to the best of their knowledge provided complete and correct information on the above application.
Should be Empty:

Future Operations Base Membership Form

Emergency Contact

Military Membership:

First Responder Membership

Widow/Widower Membership

Family Membership

F.O.B. Kids Membership

Volunteering Information