FRANKLIN FIRE COMPANY

FRANKLIN FIRE COMPANY

158 W. King Street Chambersburg, PA 17201
MEMBERSHIP APPLICATION

There is a one-time, non-refundable fee of $10.00 per application for applicants age 18+ due at the time of submission which can be paid at the link at the bottom.
Type of Membership Requested:*

OperationalNon-OperationalJunior Member (age 14-17)
Full Name*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone*
Street Address*
City*
State*
Zip*
Drivers License*
State Issued*
Class of DL*
Occupation*
Employer*
School*
Graduation Year*
Parent/Guardian Name (If under 18+):
Relationship:
Phone Number:
Beneficiary Name and Relationship:*
Beneficiary Phone Number:*
Emergency Contact Name & Relationship*
Emergency Contact Phone Number:*
Have you ever been a member of another fire department?*

YesNo
If yes list the departments past and present:
Why do you want to be a member of the Franklin Fire Company?*
Background Checks
Have you ever been charged or convicted of a crime?*

YesNo
If yes was it a felony or a misdemeanor?
Please explain your crime/conviction further:
Do you have PA Criminal Background Check from the Pennsylvania State Police?:*

YesNo
Do you have Child Abuse History Clearance from the Department of Human Services?:*

YesNo
If you have your own copies of the background checks listed above please upload a copy here!

Cancelof
Please list 3 references (Name, Phone Number, Email, and Address)*
Any false information or failure to complete the application in full may result in the termination of the application process. The Franklin Fire Company reserves the right to deny any application for any reason. By signing the application, you attest that all information listed above is true to the best of your knowledge and you agree to follow the constitution, bylaws, and rules and regulations of the Franklin Fire Company
Applicant Signature*

Clear
ParentGuardian Signature if under 18

Clear
Date*

MonthDayYear
Date
Membership Application Fee*

prevnext( X )
USD
Your application will be reviewed and voted on at the next company meeting following the submission of your application. Company meetings are held on the first Tuesday of each month. If you have questions regarding your application for membership, please email secretary@sta4.com or call 717-263-8600 and select the extension for the Secretary.
THANK YOU FOR YOUR INTEREST IN THE FRANKLIN FIRE COMPANY
Payment Methods

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FRANKLIN FIRE COMPANY

MEMBERSHIP APPLICATION

Background Checks

THANK YOU FOR YOUR INTEREST IN THE FRANKLIN FIRE COMPANY