Garrison Volunteer Fire Company Inc. Membership Application

Garrison Volunteer Fire Company, Inc

P.O. Box 252, Garrison, New York 10524
APPLICATION FOR MEMBERSHIP
Name*

First NameMiddle NameLast Name
Address*

Street Address

Apt/Suite No

CityState

Zip Code
Cell Phone Number*

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Email*
Are you 18 years of age or older?*

YesNo
If NO, state your age:
Are you currently employed?*

Yes (please provide info below)No
Name of Company
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone

Area CodePhone Number
May we contact your employer as a reference?

YesNo
Do you have a valid New York Drivers License?*

YesNo
Please indicate your availability to participate in normally required fire department activities (meetings, drills, and emergency calls).

Weekdays - DaytimeWeekdays - EveningsWeekdays - NightsWeekends - DaytimeWeekends - EveningsWeekends - Nights
Should be Empty:

Garrison Volunteer Fire Company, Inc