We are currently recruiting for new members! We have a variety of ways to get involved, from active firefighting, to fund raising, to administrative and business support, and we’re sure we can find an area that interests you.
| What type of membership are you applying for?: |
|
Junior Membership 14-17
Firefighting/Fire Police Membership 18+
Associate Membership 18+
|
| Full Name:
|
 |
|
| Present Address:
|
|
|
| City, State and Zip:
|
|
|
| How long have you lived at the above address?:
|
|
|
| Phone:
|
|
|
| Cell Phone:
|
|
|
Previous Address:
Add N/A if doesn't apply to you
|
|
|
| How long did you live at the above address?:
|
|
|
| Date of Birth:
|
|
|
| Place of Birth:
|
|
|
| Are you a U.S. Citizen?: |
|
Yes
No
|
| How were you referred to the Franklin Park VFC No. 1?:
|
|
|
| Are you capable of lifting 50 pounds repeatedly?: |
|
Yes
No
|
|
| Driver’s License Information |
|
| Drivers License #:
|
|
|
| State:
|
|
|
| Class:
|
|
|
| Experiation Date:
|
|
|
| Do you have a Commercial Driver’s License?: |
|
Yes
No
|
| Have you ever had your driver’s license revoked or suspended?: |
|
Yes
No
|
| Have you ever refused to submit to an alcohol or other type of sobriety test?: |
|
Yes
No
|
| If yes (Sobriety test), please explain:
|
|
|
|
| Criminal History |
|
| Have you ever been convicted of a Misdemeanor or Felony?: |
|
Yes
No
|
| If yes (Criminal History), explain:
|
|
|
|
| Emergency Services Experience |
|
| Have you ever been a member of an Emergency Services Organization?: |
|
Yes
No
|
| If yes (member of emergency service) please explain:
|
|
|
| Position(s) Held (Including the years in each position):
|
|
|
| List any certifications you have earned:
|
|
|
| Name of Chief, Phone or Email:
|
|
|
|
| Employment |
|
| Company:
|
|
|
| Years employed:
|
|
|
| Position:
|
|
|
| Address:
|
|
|
| Phone:
|
|
|
| Type of Business:
|
|
|
|
| Personal References |
|
| Reference Name (1), Address, Phone Number:
|
|
|
| Reference Name (2), Address, Phone Number:
|
|
|
| Reference Name (3), Address, Phone Number:
|
|
|
|
| Statement of Understandings and Authorizations |
|
| I hereby apply for membership in the Franklin Park Volunteer Fire Company No. 1 (hereinafter known as the Company) and, if accepted for membership, I will comply with the constitution, bylaws, rules, standard operating guidelines, and the conduct expected:
|
|
Bureau of Motor Vehicles of Pennsylvania
Any Law Enforcement Agency
Any emergency services agency of which I was ever a member
Any employer, past or present
|
Recommended by:
(An applicant must be recommended by 2 members in Good Standing for the Application to be read and voted on at a business meeting)
|
|
|
