Volunteer Firefighter Application Form
Personal Information
Name*
First Name Last Name
Phone Number*
Area Code Phone Number
Home/Work Phone*
Area Code Phone Number
Email*
example@example.com
Residence Address*
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code
Mailing Address (if different)
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code
Basic Requirements
Hall Preference*
Hall 1 Hall 2 Hall 3 Hall 4 Hall 5
Are you legally entitled to work in the United States?*
Are you 19 years of age or older?*
Do you possess a valid BC Class 5 Unrestricted Driver’s License and a good driving record?*
Do you have a current BC Class 3 or greater Driver’s License with Air Brake endorsement?*
Do you understand that applicants will be required to provide a Driver’s License Abstract and a Criminal Record Check for Vulnerable Sector?*
Do you believe you are free of medical conditions that may preclude your participation as a volunteer firefighter?*
Do you believe you are free of medical conditions that may preclude your participation as a volunteer firefighter?*
Are you willing to participate in a medical check required of potential volunteer firefighters?*
Are you willing to participate in a medical check required of potential volunteer firefighters?*
Do you understand that volunteer firefighters are expected to be in good physical condition, and do you feel you are physically able to participate in a physical fitness related test as part of the selection process?*
Do you understand that successful applicants are required to remain without facial hair to ensure a self-contained breathing apparatus mask will form a positive seal on the face?*
Additional Comments
Availability
Please select your availability for the given days and time phases*
Monday - Days Monday - Nights Tuesday - Days Tuesday - Nights Wednesday - Days Wednesday - Nights Thursday - Days Thursday - Nights Friday - Days Friday - Nights Saturday - Days Saturday - Nights Sunday - Days Sunday - Nights
If accepted by the Fire Department, you will be required to attend regular biweekly Thursday night practices (approximately 7:30PM to 9:30PM). Can you meet this requirement?*
Do you understand that in order to be available for emergency call-outs, you must be able to arrive at the fire station promptly and have abstained from alcohol and drugs for the previous 8 hours?*
Are you willing and able to retain and wear an emergency pager and respond to emergencies?*
Are you willing and able to participate in the occasional weekend training program?*
Skills and Experience
Please indicate if you have any of the following skills or training*
CPR - Cardiopulmonary resuscitation Certified Trade - mechanic, electrician Fire Safety Systems - alarms, extinguishers Rescue procedure - lifeguard, auto extrication First Aid Knowledge of breathing apparatus - scuba diving, etc PAD/Defibrillation Training Occupational Health & Safety
Previous Emergency Volunteer Experience - Explain:
Previous Firefighter Experience – Explain:
References
Terms and Conditions
Date
Month Day Year
Date
Signature
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Volunteer Firefighter Application Form

Personal Information

Basic Requirements

Availability

Skills and Experience

References

Terms and Conditions