City of Frazee Fire Department
Volunteer Firefighter Application
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone
*
-
Area Code
Phone Number
Alternate Phone (Mobile, etc.)
-
Area Code
Phone Number
Email
*
example@example.com
Do You have truck driving experience?
*
Yes
No
What type of truck?
Name of Employer
Employment City
Type of work?
What hours do you work?
Do you have permission from your employer to respond to calls during work hours?
Yes
No
Which hours are you unable to respond and reason?
Is your spouse or significant other agreeable to your joining the Frazee Fire Department.
*
Yes
No
Not Applicable
Are you bothered by height or Claustrophobia.
*
Yes
No
Do you have any physical, mental, or medical impairments or disabilities, which would prevent you from being an active member of the Frazee Fire Department.
*
Yes
No
Please explain:
Have you ever injured your back?
*
Yes
No
If yes, please explain.
Do you have any present commitments that would prevent you from becoming an active member of the Frazee Fire Department?
*
Yes
No
If yes, please explain.
Please list any skills or abilities you feel would compliment the Frazee Fire Department.
Who were you referred/recommended by to become a volunteer firefighter with the City of Frazee?
I HEREBY CERTIFY THAT ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I HEREBY APPLY FOR MEMBERSHIP WITH THE FRAZEE FIRE DEPARTMENT AND AGREE TO ABIDE BY ALL RULES AND REGULATIONS OF THIS ORGANIZATION.
*
I have read, understand, and agree to this statement.
Your Signature
*
Date Completed
Please verify that you are human
*
Submit Application
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