Mason County SAFER Grant Program P.O. Box 277 * NE 460 Old Belfair Hwy * Belfair, WA 98528 (360)275-6711 ext. 7 * (360)801-0590 Fax: (360)275-6224 Email: Volunteer Coordinator Tina Miller at tmiller@northmasonrfa.com Strengthen You and Your Community: Volunteer Today! The Mason County Staffing for Adequate Fire and Emergency Response, (SAFER) Grant Program is a four year Federal Grant that was awarded in 2013. This SAFER Grant provides the funding for the essential training, uniforms and protective gear for forty two Volunteer Firefighter and Emergency Medical Technicians within Mason County. These funds ease the process and hardship for Volunteers that are willing and committed to the training program. Whether it is a fire or medical emergency it is our volunteer personnel responding to the aid of others that make a difference. You can make a difference by becoming a Volunteer. As a Volunteer you will play a vital role in the pursuit of providing lifesaving actions when seconds count and reducing emergency response time. We need you! SAFER Partners include: North Mason Regional Fire Authority (NMRFA) Main station located 460 NE Old Belfair Hwy, Belfair, Mason County Fire District 3 (MCFD3) Main station located 4350 E Grapeview Loop Rd, Grapeview, Mason County Fire District 4 (MCFD4) Main station located 2970 SE Arcadia Road, Shelton, Mason County Fire District 6 (MCFD6) Main station located 50 E Seattle ST, Union, Mason County Fire District 11 (MCFD11) Main station located 130 E Island Lake Road, Shelton. Volunteer opportunities available can vary depending upon the preference of the Fire District or Fire Authority. There are three common avenues in which to volunteer: 1) Become a Volunteer Firefighter and/or Emergency Medical Technician (EMT), 2) Become a Student Volunteer or 3) Become a Community Response Team Member (CRT) or First Responder. As a Volunteer you are a representative of the Fire District or Authority. You will have numerous opportunities to participate in community events such as pancake feeds, Tahuya Salmon Bake and Safety Days to name a few. Being a Volunteer is a rewarding and valuable way to serve and give back to your community, while simultaneously pursuing personal and professional goals. There are numerous benefits in being a Volunteer for Mason County, here are just a few: Respond and render assistance on actual emergency calls; Take advantage of numerous training opportunities in emergency response; All equipment, supplies, training and uniforms are provided to Volunteers at no cost; Work side by side with career Firefighter EMT s and Paramedics to build skills; Opportunities are provided for emergency service career paths; Pension and Disability is provided; Life and accidental death insurance is provided for on duty activities; Gym memberships for physical fitness are provided. (Depending on location)
Volunteer Firefighter/Emergency Medical Technician (EMT) Volunteer Firefighters are responsible for work performed in combating, extinguishing and preventing fires and in the protection of life and property. Volunteer personnel are critical in performing fire suppression and prevention, public education and other emergency service activities. Some of the duties of a Volunteer Firefighter/EMT are rescuing people from cars and burning buildings and administering first aid. Duties may also include support services under the close supervision of a duty officer. Volunteer Firefighters must also be proficient in operating tools such as, the Jaws of Life or a chain saw and fire hose. We are looking to train the right people. Individuals selected will benefit from a great program that we have customized just for you. As a Volunteer Firefighter/EMT you will receive approximately 400 hours of training in the following areas: Firefighter I and Firefighter II; Emergency Medical Technician; Search and Rescue; Wildland Firefighting; Hazardous Materials; Basic Life Support and First Aid; Traffic Control; Emergency Vehicle Incident Preparedness. Student Volunteer Firefighter At this time this program is only offered with North Mason Regional Fire Authority. The Student Volunteer Firefighter is designed for individuals who are seeking a professional career in the fire service. Training, responsibilities and benefits are similar to a Volunteer Firefighter/EMT. The positions are highly coveted and competitively selected as the Fire Authority maintains only nine positions for Student Volunteers. The program requests Student Volunteers make a minimum two year commitment and provides training that is comparable to higher education, learning at local technical colleges. Student Volunteers work side by side with career firefighters and paramedics to learn skills and abilities to obtain a job in the Fire Service. Over half of the Authority s career Firefighters and Paramedics have been hired from the NMRFA s Student Resident Volunteer Program. Student Volunteers receive a monthly stipend to assist with expenses. Student Volunteers are assigned a shift and work alongside the staff assigned to that shift. Shifts are 48 hours on and 96 hours off. All expenses for equipment and training are provided by NMRFA. Community Response Team Members (CRT) The Community Response Team (CRT) very similar to a First Responder. The CRT program is based on the philosophy of neighbors helping neighbors. It is designed for individuals who want to help their community and neighbors during an emergency but do not wish to fight fires or engage in intense training. They are trained in First Aid and CPR, Disaster Response, and Incident Command. CRT members do not extinguish fires, but instead they support the Firefighters and Paramedics. The initial CRT training is limited to 50 hours and it is conducted in the evenings, on a schedule that is convenient. Ongoing training is conducted once a month for 2 hours in duration. All training and response equipment is provided by the NMRFA. Individuals ages 18 and older are encouraged to apply. Training includes: First Aid and CPR; Disaster Response; Incident Command and Firefighting Assistance; Real life experiences on actual emergency calls. Thank you for your interest in Volunteering! We can t wait for you to begin. -Tina Miller 1
Mason County Grant Safer Program P.O. Box 277 / 460 NE Old Belfair Hwy, Belfair, Washington 98528 Office: (360) 275-6711 Ext. 7 / Cell: (360) 801-0590 / Fax: (360) 275-6224 Applications will be screened immediately. Applicants will be contacted for interviews and assessments following the review. If you are selected for the assessment process and need special accommodations due to impairment or disability, or any questions regarding application process please contact Volunteer Coordinator Tina Miller at 360-275-6711 Ext 7 or by email at tmiller@northmasonrfa.com. Volunteer Application APPLICANT INFORMATION Last First M.I. Date of Birth: Residence Street Address Apartment/Unit # City State ZIP Code How long at this address? Mailing address: Street Address City State ZIP Code Telephone: Cell Email: Desired training level: Date Available: Do you have, or can you obtain a Washington state driver s license? Have you ever volunteered before? Have you ever been convicted of a felony? If yes, explain: If yes, when? 2
EDUCATION High School: Highest grade level achieved? : From: To: Did you graduate? Diploma: College: Course of Study: From: To: Did you graduate? Degree: Other: Course of Study: From: To: Did you graduate? Degree: List below valid licenses or certificates of professional or vocational competence relevant to the volunteer position for which you are applying. License/Certificate : License/Certificate Number: Expiration Date: 1) 2) 3) 4) Please list three professional references. REFERENCES 3 Relationship: Relationship: Relationship:
PREVIOUS EMPLOYMENT Supervisor: Job Title: Responsibilities: From: To: Reason for Leaving: May we contact your previous supervisor for a reference? Supervisor: Job Title: Responsibilities: From: To: Reason for Leaving: May we contact your previous supervisor for a reference? Supervisor: Job Title: Responsibilities: From: To: Reason for Leaving: May we contact your previous supervisor for a reference? MILITARY SERVICE Branch: From: To: Rank at Discharge: Type of Discharge: If other than honorable, please explain: 4
MISCELLANEOUS How did you hear about this Volunteer opportunity? (Please provide specific name of media whenever possible.) Word of Mouth: Advertisement in: Website: Other: TICES The Mason County Fire Districts (MCFD) and North Mason Fire Regional Authority (NMRFA) are equal opportunity agencies. MCFD s and NMRFA maintain policies of non-discrimination with members and applicants. MCFD s and NMRFA will not unlawfully discriminate in any aspect of membership or applicants for membership based on race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, pregnancy, disability or status as a disabled veteran or Vietnam era veteran, or any other basis prohibited by law. MCFD s and NMRFA will accommodate applicants and employees with disabilities as required by law. MCFD s and NMRFA are a smoke and drug free work place. You will be required to complete a drug test prior to membership. CANDIDATE AUTHORIZATION AND CONSENT FOR RELEASE OF INFORMATION I certify that I am not engaged in any outside activity or business that could be considered in conflict with the MCFD s or NMRFA interest or those of its clients, nor will I become engaged in such activity or business if accepted. I, the undersigned applicant for membership with the MCFD s or NMRFA, in consideration of the review of my membership application, do authorize the MCFD s or NMRFA to solicit information regarding my character, general reputation, previous employment, and similar background information, and to contact any and all references I have given on my application. I hereby release all parties and persons connected with any such request for information from all claims, liabilities, and damages for any reason arising out of furnishing such information. If employed, I release the MCFD s and NMRFA from any liability for future references it may provide regarding my employment with the MCFD s and NMRFA. Pursuant to RCW 43.43.834, background checks are available to the applicant upon request. It is my intention that any copy of this authorization be as effective as the original. Applicant - Please Print Name Date Applicant s Signature 5
DRIVING RECORD Name: Please Print Last First MI Driver license number (s) License Number State License Number State License Number State List all notices of infractions or traffic citations (other than parking tickets), which you have received in the past 5 years. State Month/Year Type of Infraction Infractions or citations will not necessarily remove you from consideration. The MCFD s and NMRFA will; however, consider your driving record when making membership decisions. Signed: Date: DISCLAIMER & SIGNATURE I certify that my answers are true and complete to the best of my knowledge. I understand that any misstatement, failure to answer fully or omission of fact in this application my result in my not being considered in the selection process or may result in my dismissal after membership. I have read the Volunteer descriptions and I can perform the essential functions of the job for which I am applying, with or without reasonable accommodation. I understand that acceptance of an offer of membership does not create a contractual obligation upon the MCFD s and NMRFA to continue to retain me in the future. For determination of my potential membership eligibility, I hereby authorize release of educational, police, criminal and employment information pertinent to the position for which I am applying. I further authorize the MCFD s and NMRFA to rely upon and use, as it sees fit, any of the information received. Signature: Date: MAIL, EMAIL, FAX or DELIVER your completed application to: Tina Miller, Volunteer Coordinator PO Box 277, Belfair, WA 98528 Fax: 360-275-6224 Email: tmiller@northmasonrfa.com Office hours: Tuesday through Friday 9:00 am - 5:00 pm 6