Teals Mill FD Application

Teal's Mill Rural Volunteer Fire Department

Application for Volunteer Firefighter
Full Name

First NameMiddle NameLast NameMaiden
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date

MonthDayYear
Drivers License

NumberState / Class
Email Address
example@example.com
Social Security Number
Cell Number
Home Number
Please enter a valid phone number.
Gender

Street Address

Street Address Line 2

State / Province

Postal / Zip Code
Highest level of Education
Gender 2
Skills

Special Skills (Machines, Equipment, etc...)

List any special certifications you have (EMT, Fire Fighter I, II, Instructor, etc...)

CityState / Province

Postal / Zip Code

Answer Yes or No in the first column, Initial your response in the second, any additional information can be added for the third collumn.*

	Yes / No	Initial	Additional Info
I will take all of the REQUIRED FIRE DEPARTMENT TRAINING.
I have past Military Experience (if Yes please put highest rank)
I WILL ATTEND THE FIRE DEPARTMENT MEETINGS EVERY 1ST AND 3RD TUESDAY OF EVERY MONTH.
I will go to all fires as much as possible.
I WILL NOT BE ON A FIRE WHILE DRINKING.
I will no use profanity while at a fire, meeting, or function that I am attending with the Fire Department.
I will help with all fund raising projects.
I will not talk bad about the fire department in any way.
I will participate in all training exercises.
I will OBEY all commands of the OFFICER IN CHARGE.
I will remain on duty when answering a call, and will RETURN TO THE STATION unless excused by the OFFICER IN CHARGE.
I understand that if I MISS MULTIPLE FIRES AND MEETINGS (UNLESS EXCUSED BY THE CHIEF/OFFICER) that I am no longer a firefighter for the Teal's Mill FD and will turn in all equipment issued to me.

I, First Name Last Name , certify that the above information in this application is true, complete, and correct to the best of my knowledge. I understand that false information may be grounds for rejection of my application.
Signature

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Teal's Mill Rural Volunteer Fire Department