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
Other
Previous Emergency Volunteer Experience - Explain:
Previous Firefighter Experience – Explain:
References
Terms and Conditions
Date
-
Month
-
Day
Year
Date
Signature
Submit
Should be Empty: