Department Application

Background Investigation
Have you ever been suspended / removed from an emergency services orginization?

YesNo
If Yes please explain
Have you ever been convicted of a crime or offense?

YesNo
If Yes please explain including date, jurisdiction and crime / offense.
Have you ever been a plaintiff or defendant in a domestic violence incident?

YesNo
If Yes please explain including date, jurisdiction and crime / offense.

Seasonal Membership Information

To be completed by applicants wishing to apply as a seasonal member.
Current Active Fire Department
Point of Contact Name / Phone Number
Seasonal Members are required to complete two observational ride alongs prior to their applications being processed. To schedule your ride along please click the below link and complete the form.

Ride Along

Certification
I certify that the statements made within this apllication are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I am aware that any misrepresentation of information supplied by me will result in my disqualification from the selction process.

Futhermore, I authorize the Sea Bright Police Department to verify any and all information contained herein and to review my employment, education and criminal histroy in addition to any disciplinary records and information from any source as noted in this duly executed release form.

I have read this certification and I understand and agree to the conditions imposed herein.
Name

First NameLast Name
Date

MonthDayYear
Date
Should be Empty:

Sea Bright Fire Rescue