VOLUNTEER FIRE DEPARTMENT

Similar documents
Fire & Rescue. Application & Information Packet

Peoria Heights Fire Department. Membership Application Packet

Application for Contracted Services

CITY OF FOUNTAIN VOLUNTEER FIRE FIGHTER

Independent School District No Browns Valley Public Schools. Application Form

APPLICATION FOR EMPLOYMENT FIREFIGHTER / PARAMEDIC POSITION

Prairie City EMS Department. EMS Department 203 E. Jefferson Street Prairie City, Iowa 50228

Volunteer Firefighter Recruit Requirements and Application Procedures

EMPLOYMENT APPLICATION

Search and Rescue Unit Volunteer Application

King and Queen County Treasurer 242 Allen s Circle, Suite H P O Box 98 King and Queen CH., VA (804) or (804)

City of Tomah Tomah Area Ambulance Service Employment Application

APPLICATION FOR EMPLOYMENT. Directions: Fill out this application in its entirety using blue or black ink.

CITY OF GLENDALE APPLICATION FOR POLICE OFFICER CHECK LIST

THE MANCHESTER FIRE ENGINE AND HOOK AND LADDER CO., NO.

The Marion County Sheriff s Office

AUSTIN/MOWER COUNTY LAW ENFORCEMENT RESERVE APPLICATION PACKET

NON-TEACHING APPLICATION

Last Name First Middle Initial Maiden Name (if applicable)

WHITMAN COUNTY CIVIL SERVICE COMMISSION

EMPLOYMENT APPLICATION

Strengthen You and Your Community: Volunteer Today!

VERMONT JUDICIAL BRANCH EMPLOYMENT APPLICATION

Weisenberg Volunteer Fire Department P.O. Box 51 Kutztown, PA 19530

Carlisle Police Department Employment Application

Office of Financial Aid Scholarship Application

Firefighter Application Packet City of Texarkana, Texas

EQUAL EMPLOYMENT OPPORTUNITY DATA FORM Please Return to: City of Geneva Human Resources 22 South First Street Geneva, IL 60134

EMPLOYEE FILES. Applying for the Job

Scott Ellis CLERK OF THE CIRCUIT AND COUNTY COURTS BREVARD COUNTY, FLORIDA

KING AND QUEEN COUNTY

Wyoming County Employment Application

APPLICATION FOR EMPLOYMENT

Kittanning Volunteer Fire Departments 1-4-6

Cahokia Volunteer Fire Department. Application for Membership

LEAGUE CITY VOLUNTEER FIRE DEPARTMENT

Sheriff Wes Drury Scott County Sheriff s Office P.O. Box South New Madrid Street Benton, Missouri Phone: Fax:

SCHOOL BUS DRIVER APPLICATION

Community Emergency Response Team (CERT) Volunteer Application Douglas County Citizen Corps Council Douglas County Sheriff s Office

HAMILTON COUNTY SHERIFF S OFFICE 1000 SYCAMORE STREET, ROOM 110 CINCINNATI, OHIO OR HAMILTON AVE, PATROL HEADQUARTERS

EMPLOYMENT PROCEDURES FOR PARAPROFESSIONAL STAFF

Please complete this application by pen (print) or typewriter in its entirety. PERSONAL INFORMATION. First MI Last. Street City State Zip

Application for Employment. Page 1 07/18

Last Name: First Name: Middle Name: Street Address: City: State: Zip Code: Home Phone: Work Phone: Cell Phone: May We Call You at Work?

Jefferson County Sheriff s Office 200 Courthouse Way, Rigby, ID PH# ~ FX#

Application for Admission

Application for Employment

INTERNATIONAL SCHOOL OF MIDWIFERY, INC. 140 NE 119 Street Miami, Florida (305) Fax (305)

Woodstock Volunteer Fire Association

South Gwinnett Athletic Association Volunteer Football Coach Application Form

EMPLOYMENT APPLICATION & INSTRUCTIONS

Training Opportunity!

2016 Counselor In Training Program Application

Rutherford Co. Rescue

North Carolina Extension Master Gardener Volunteer Application Guilford County

SARATOGA SPRINGS PUBLIC LIBRARY 49 Henry Street, Saratoga Springs, NY (518) Fax: (518)

Application for Graduate Admission

EMPLOYMENT PROCEDURES FOR SUBSTITUTE TEACHING STAFF

COMPEER PROGRAM VOLUNTEER APPLICATION

Marion Fire Cadet Program

Naperville Emergency Management Agency New Volunteer Package

Application for Admission School of Medical Laboratory Science

Coaches Code of Conduct

MT. WASHINGTON FIRE PROTECTION DISTRICT 772 NORTH BARDSTOWN ROAD MT. WASHINGTON, KY

Pawling Central School District 515 Route 22 Pawling, NY (845) (845) Fax

STANDARD OPERATING GUIDELINES

CHRISTIAN COUNTY SHERIFF S OFFICE CORRECTIONAL CENTER * CENTER 301 W. FRANKLIN STREET P. O. BOX 678 TAYLORVILLE, IL 62568

Township of Lower Salford, Montgomery County 379 Main Street, Harleysville PA 19438

Application for Employment. An Equal Opportunity Employer

SUMMER INTENSIVE RESIDENT ASSISTANT APPLICATION PACKET

Township of Lower Salford, Montgomery County 379 Main Street, Harleysville PA 19438

Instructions for SPA Paper Application

DELTA STATE UNIVERSITY ROBERT E. SMITH SCHOOL OF NURSING RN TO BSN COMPLETION PROGRAM APPLICATION

Scholarship Instructions Applications Due Date: March 20, 2017

For tuition prices please contact our school.

Girl Scouts of Greater South Texas Volunteer Policies

LEAGUE CITY VOLUNTEER FIRE DEPARTMENT 555 W. Walker League City, TX Phone

State Trauma Program Coordinator $88,656 $110,088 annually, commensurate w/ training and experience

MSN Program Application Process Checklist

Application for Admission

Last Name First Name Middle Initial Today s Date. Desired Shift Day Shift Night Shift

BATTLE LAKE FIRE DEPT. 107 SO. GARFIELD AVE. BATTLE LAKE, MN

APPLICATION FOR BENEFITS LAW ENFORCEMENT OFFICERS AND FIRE FIGHTERS DISABILITY BENEFITS TRUST FUND

Our EEOP Report is available on request in the JPSO Human Resources Office.

HAMILTON COUNTY SHERIFF S OFFICE SPECIAL DEPUTY APPLICATION

GLYNN COUNTY SHERIFF S OFFICE IS AN EQUAL OPPORTUNITY EMPLOYER

PO BOX 535 BROOKLYN IA PHONE: FAX: APPLICATION FOR EMPLOYMENT PLEASE PRINT

Network Participant Credentialing Application

6965 Cumberland Gap Parkway Harrogate, TN nursing.lmunet.edu Family Nurse Practitioner Concentration

Gilmer Independent School District 500 So. Trinity Gilmer, Texas Phone: (903) FAX: (903)

DUKE HEALTH CHARITABLE GIVING POLICY

Mission Statement Flint Township Fire Department is dedicated to promoting safety, saving lives, and fighting fires. We accomplish this by being

Town of Southampton Police Department

Illinois Emergency Services Management Association Emergency Management Assistance Team. Membership Application. Name: Home Address: City: Zip:

University of Florida Career Resource Center Third Party Employment Services POLICY STATEMENT

Original Effective Date: April Policy Number 0.0. Page Last Revision Date: October of 6 Revision Effective Date: January 2016

Grand Prairie Fire Department Applicant Identification Form

!!! Program Referral Checklist. Assessment for Determining Eligibility. Vocational Rehabilitation Needs. Medical and Psychological Reports

MILLERS COLLEGE OF NURSING

Coos Bay Fire & Rescue. Volunteer Firefighter Program

Transcription:

U E VOLUNTEER FIRE DEPARTMENT

INTRODUCTION Please read the fol lowing Introduction statement before oompletlng the application form... As an appl ioant for the Humble Volunteer Fire Department, you should have a strong desire to serve others, be eager to study, work hard and be wi Iling to make necessary sacrifices to learn the ski IIs and fundamentals of fire fighting. You must understand that the protection of life and property depends on your knowledge, training, experience and courage. The art of fire fighting requires long and difficult days of preparatory training for that time of emergency when you suddenly become one of the most important persons in the community. As an Humble Volunteer Fire Fighter, you wi II be trained in the essentials of fire fighting, communications, safety, fire prevention, operation of fire apparatus, rescue, first aid and hazardous materials awareness. To function safely and effectively in the fire service, it is essential that you train extensively. You wi II be expected to devote many hours to learning your role as a fire fighter. (Please note that your inability of unwillingness to train and/or respond to a sufficient number of emergency alarms will not be tolerated and could result in your dismissal) Prior to your becoming an active probationary member and within 30 days of being voted into the organization, you wi II be required to suocessful Iy complete a Fire Department provided PHYSICAL EXAMINATION. Your probationary period wi II be a minimum of SIX (6) MONTHS. If you are successful in completing your probationary period, you wi II then be considered for 1..!:U.l membership into the Volunteer Fire Department. AI I uniforms, personal protective equipment, on-duty accident and life insurance wi I I be prov ided by the Fire Depar tment. In addition, as a ful I member you wi I I be enrol led into the Texas Statewide Volunteer Fire Fighters' Retirement Fund. IF YOU FEEL THAT YOU ARE QUALIFIED AND YOU WANT A COMMUNITY SERVICE POSITION THAT OFFERS A REWARDING CHALLENGE, THEN COMPLETE THE ATTACHED APPLICATION. YOU MAY BE THE PERSON COMMUNITY NEEDS!!! YOUR

HUMBLE VOLUNTEER FIRE DEPARTMENT APPLICATION FOR MEMBERSHIP (The HumbleVolunteer Fire Departmentconsiders al I appl icants for membershipwithout regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status,) Date of Appl ication: (PLEASE TYPE OR PRINT) Last Name First Name Middle Name (Number Street Apt.# City State Zip Number(s) Social Security Number I I Are you 18 years of age or older? Yes No Have you been convicted of a felony within the last 7 years? (Conviction wi I I not necessari Iy d isqual ify an appl icant) If Yes, please explain Yes No Texas Drivers License Type: Marital Status: Married Single Number of Dependents education Years Completed Diploma/Degree High School Col lege/university Other (Spec ify)

MERGENCY INFORMATION Next of Kin: City: Zip: May this person be notified if you are injured? Yes No If no, whom may we notify if you are injured? Name: City: Zip: FIRE SERVIC EXPERIENCE List al I prior fire service experience. Give years of service, the fire service organization affi I iated with, dates of service and telephone number of service. List any special fire service training or ski I Is: (If you need additional sheet of paper) space, please continue on a separate EMPLOYMENT Present Employer Employer: City: State: Zip: May the Humble Volunteer Fire Department contact your current employer? Yes No

What are your reasons for joining the Humble Volunteer Fire Department: Appl icant's Statement I certify that I have read and understood the introduction portion of this appl ication package and I further certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of al I statements contained in this appl ication for membership into the Humble Volunteer Fire Department as may be necessary in arriving at a decision. I further understand that it is my responsibi Iity to update these answers should any change occur during my tenure in the Humble Volunteer Fire Department. Signature: Date: THIS SPACE TO BE FILLED OUT BY FIRE DEPARTMENT PERSONNEL Appl ication received by: Date: Sponsored by: Committee action: Probation: Approved Disapproved Officers present: Remarks: