Manassas Volunteer Fire Company, Inc
9322 Centreville road, Manassas VA 20110
Auxiliary
Membership Application
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Medical Information
Do you have any physical conditions or illnesses that might prevent you participation as an Auxiliary member in fire company activities? If yes please explain below.
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Yes
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Have you ever had epilepsy or any other mental or nervous aliment, or have been a patient in an institution for treatment of such ailment? If yes, please explain below.
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Emergency Contact Information
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