East Hants Fire Service Volunteer Firefighter Application

EAST HANTS FIRE SERVICE MEMBERSHIP APPLICATION
Personal Information
Department Applying For
Are you over the age of 18

YesNo
Applicant Name

First NameInitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Driver's Licence Information
Master Number
Class
Endorsements
Years of Driving Experience
Education and Work History
Are you Currently Employed?

YesNo
Name of Current Employer
What is your Job Title?
Current/Previous Firefighting Experience

Note: Proof Required
Fire Service Experience (Years)
Name of Fire Department
Position
Level of Qualification/Training
Do you have Medical Training?

YesNo
Please specify your medical training:
Do you have any unique qualifications relevant to firefighting?

YesNo
Please specify your relevant training:
Acknowledgements
I hereby apply for membership in the East Hants Fire Service. I understand that I shall be required to submit the following documentation:
1. Vulnerable sector check
2. Medical eligibility form (Annex B)
3. Previous fire service records
4. Medical training
I acknowledge and understand
All documentation shall be completed prior to processing the application. I agree to be interviewed by the membership committee to discuss suitability for membership, covering any or all of the following topics:
1. Vulnerable records check results
2. Medical eligibility form results
3. Previous fire service
4. Medical training
I acknowledge and understand
The membership committee shall make a recommendation to the department as to the suitability of the applicant. Submitting an application does not guarantee membership. Any false statements on this application are grounds for immediate rejection.

I acknowledge and understand
If accepted:
1. I agree to adhere to the Constitution and Bylaws, Polices, and Guidelines of the Department.

2. I agree that any equipment, uniforms, protective clothing, training materials, identification cards, or any other items which may be provided for my use, is the property of the Department and shall be promptly returned to the Department upon my leaving the Department, whether by resignation, termination or any other means.

3. I agree that participation in Department activities may make me privy to information about citizens of the fire protection area, members of the Department, Departmental activities, or other information of a personal or confidential nature and I will not reveal or discuss, except as required to carry out my duties as a member of the Department and will sign a non disclosure agreement to that effect.

4. I agree that I will be expected to attend all incidents, training sessions, and monthly business meetings and assist with fund raising activities when available.
I acknowledge and understand
In the filing of this application, I understand that by my lack of participation for a period of three months, I shall be presumed to have resigned.

I acknowledge and understand
Name of Parent/Guardian
Date

MonthDayYear
Date
Applicant Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

EAST HANTS FIRE SERVICE MEMBERSHIP APPLICATION

Personal Information

Driver's Licence Information

Education and Work History

Current/Previous Firefighting Experience

Acknowledgements