Volunteer Firefighter Application Form

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Home/Work Phone*

Area CodePhone Number

Email*

example@example.com

Residence Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mailing Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Hall Preference*

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?*

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

Please select your availability for the given days and time phases*

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?*

Please indicate if you have any of the following skills or training*

CPR - Cardiopulmonary resuscitationCertified Trade - mechanic, electricianFire Safety Systems - alarms, extinguishersRescue procedure - lifeguard, auto extricationFirst AidKnowledge of breathing apparatus - scuba diving, etcPAD/Defibrillation TrainingOccupational Health & SafetyOther

Previous Emergency Volunteer Experience - Explain:

Previous Firefighter Experience – Explain:

Date

Signature

Volunteer Firefighter Application Form

Personal Information

Basic Requirements

Availability

Skills and Experience

References

Terms and Conditions