PVFD Membership Application

Petersburg Volunteer Fire Department

Membership Application

01/15/1911

123 Home St, or Stall 48, North Harbor, Etc

Any prior certifications experience you have held, include any skills you have that might help the dept.

i.e. Anyman's Hardware Store

References:

(At least one local reference and one professional reference)

Please enter a valid phone number.

I certify that my answers upon this application form are true. I authorize investigation of all statements on this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. I also agree to provide volunteer service to the community in the branches checked above for a period of not less than two years upon being accepting into membership. I also agree to follow the department's by-laws and policies. Please attach a copy of a background check to this application. You will be reimbursed after one year of acceptable service for the cost of the background check.