LVRS Contact Form
Please use this form to have someone from the Membership Committee to contact you about volunteering at Laurel Volunteer Rescue Squad.
Name:
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
What type of membership category are you interested in?
*
Active Operational
Administrative Support
Have read and understand the duty commitment for the membership category you are applying for?
*
Yes
No
Type of Interest:
*
EMS
Fire/EMS
Are you 18 years old or older?
*
Yes
No
Are you interested in our live-in program?
*
Yes
No
Are you currently a member of another Prince George's county fire station?
*
Yes
No
Are you 16-17 years of age and interested in our cadet program?:
*
Yes
No
Best Method for Contact:
*
Email
Phone
Best time to contact
*
Please Select
Morning
Afternoon
Evening
Night
Additional comments/Current Cerfitications
How did you find out about us?
*
Google search/Company Website
Referral
Driving/Walking by the station
Saw us on social media
Community outreach event
Other
Were you referred to by a Current/Former Member? If so, please list their name:
First Name
Last Name
Submit
Should be Empty: