New Member Application Form
Border City Fire Department 352 US-20 Waterloo, NY 13165 bcfd.serven@gmail.com
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Date
-
Month
-
Day
Year
Date
Date of Birth
Have you ever been convicted of a crime?
Yes
No
If you selected "yes" please give a brief description below.
Which area are you interested in?
Interior Firefighter
Exterior Firefighter
EMS
Fire Police
Corporate
Auxiliary
Do you have prior experience?
Do you agree to signing a 5 year commitment contract?
Yes
No
To the best of your knowledge, have you provided accurate and truthful information?
Yes
No
Please upload a copy of your drivers license or state ID.
Browse Files
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Choose a file
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Please upload any certifications you would like to submit.
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Signature
Continue
Continue
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