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