Second Alarmers Application

Application for Membership
Please read the following Member Requirements before Submitting this Application

Applicants will understand that the information given will be verified and a background check will be conducted. Applicants will be subject to all policies governing such applicants, and no full membership status is granted until all probationary requirements in effect are satisfied. The Philadelphia Second Alarmers Association retains the right to restrict membership at any time. All membership actions taken by the Association are Final
Name*

First NameLast Name
Date*

MonthDayYear
Date
Signature*

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Your signature above indicates your understanding of the provisions of this application and that you agree to abide by all by laws and directives set forth by the Officers and members of the Second Alarmers Association and Rescue Squad of Philadelphia, Incorporated. No express or implied membership processing timetable shall be understood

Membership Requirements
Basic:

- Minimum of 18 Years old

- Express Good Moral Character

- Have a Valid Drivers License in either PA or NJ

- Possess either a High School Diploma or its Equivalent [GED]

Membership to the Association requires a commitment of the following;

- 20 Hrs a month served through either onscene activities, details, or work at the station.

- Members are required to attend 8 of the 12 monthly meetings throughout the year. Meetings areheld on the first Monday of each Month at 8:00 PM, except if that Monday falls on a holiday, orthe eve of a Holiday. If this is the case, the meeting will be held on the following Monday
Brief Description of the Philadelphia Second Alarmers

The Philadelphia Second Alarmers Association, has a long and storied history of assisting Philadelphia’s Emergency Service Personnel, through our Rest and Rehab Services. We have been providing this service since November of 1921 with Pride. We staff our station @ 2900 Roberts Ave 24/7, 365 days a year with our dedicated Volunteers. We respond to all working fires and major incidents, as well as assist the Cities Police and Fire Departments during major events through our Rest and Rehab services. We are not on the front lines, but we stand ready, and are proud to assist these members whenever and however we can. The Philadelphia Fire & Police Departments provide Exceptional service to the city of Philadelphia, and our goal is to provide Exceptional Rest and Rehab Services to them

The Application Process
Step 1: Application Received and completed by the Applicant.

Step 2: Application submitted to the Second Alarmers for Review.

Step 3: Upon completion of the Application Review process, if selected, Applicants will be set up for aninterview.

Step 4: If the Applicant passes the application and interview phase, the Recruitment Officer will put in arequest for membership in the next Association Meeting. After this request is submitted, the membershipwill vote on whether to accept or deny the applicant.

Step 5: Affirmed applications shall be followed by a letter from the Association Secretary tothe applicant indicating that he has been accepted as a Probationary Member for a trial periodof twelve (12) months
Physical Requirements

- Ability to lift 20 - 50 lbs on a regular basis.

- Ability to lift and bend in order to transport heavy equipment.

- Ability to walk distances while carrying 30 lbs of equipment or more.

- Standing for long periods of time.

Special Hazards

- Extreme weather conditions [Heat, Cold, Rain, Etc.]

- Atmospheric Hazards [Smoke, Etc]

- Walking Hazards [Hoselines, debris, various Fire Fighting equipment]

- Exposure to potentially dangerous situations.

- Emergency Response
Date*

MonthDayYear
Date

Applicant Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number*
NO DASHES, NUMBERS ONLY
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Drivers License/ID #*
Issued State*
Expiration Date*

MonthDayYear
Date
Has your Driver's License ever been suspended? Yes / No [If yes, Please Explain*
Education*

High SchoolSome CollegeAssoc DegreeBA/BSPost Graduate
Special Certifications Held [Only if Applicable] [EVOC, CPR, First Responder, etc]

Please list any Physical Limitations:
Please list any skills or qualifications you possess, that you feel will be of benefit to the Association:
Define your current work status*

RetiredUnemployedEmployedPart Time (Retired with Part Time work)

You answered Unemployed, Please explain why you are currently unemployed and your current gap in work history
Type a question*

Work History

Please list previous work history for the last 2 years, starting with your most current employer. Please explain any gaps in unemployment
Current Employer (If unemployed please explain)*
Start Date*

MonthDayYear
Date
Supervisor Name*
Supervisor Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Employment
Employer*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Supervisor Name*
Supervisor Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Employment (Continued)
Employer
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Supervisor Name
Supervisor Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Employment (Continued)
Employer
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Supervisor Name
Supervisor Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you have any current or past Volunteer history?*

YesNo

Volunteer History

Please list any and all Organizations you currently or previously have served with. Please remember to include contact information, address, and a supervisors name for verifications purposes
Organization Name*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Supervisor*

First NameLast Name
Supervisor Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reason for leaving*
Volunteer History (Continued)
Organization Name
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Supervisor Name

First NameLast Name
Supervisor Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reason for leaving

CHARACTER REFERENCES

Below list [3] Character references. Character References cannot be family members. If a reference does not answer, or return a call to the Association, another reference will be requested by the Association. Failure to Complete all reference info will result in applicant disqualification
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to Applicant*
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to Applicant*
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to Applicant*

Optional Comments before submission
Type Below
Should be Empty:

Application for Membership

Please read the following Member Requirements before Submitting this Application

Membership Requirements

Brief Description of the Philadelphia Second Alarmers

The Application Process

Applicant Information

You answered Unemployed, Please explain why you are currently unemployed and your current gap in work history

Work History

Previous Employment

Previous Employment (Continued)

Previous Employment (Continued)

Volunteer History

Volunteer History (Continued)

CHARACTER REFERENCES

Optional Comments before submission