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Join the Department

Fill out the online form below to submit your application over the internet or open the application to print it and mail it in. This form will be submitted using your local email application. If you use a web based email client you may have trouble submitting this form.

Click here to print the application and return it to us by mail.



Name:
Date: 
Address:
Date of Birth:
Sex: 
Telephone #:
Married:
YES NO
Spouse's Name:
Education:
High School (Diploma or G.E.D. Required) College
College Major (or any course work that may be helpful to the department):
Can you attend business and training meetings? Yes NO (business 1st Wed., fire training 3rd Wed., EMS training 4th Wed.)
Employer Shift
Any physical impairments?
Afraid of heights?   YES NO Are you claustrophobic? YES NO
Any first aid or EMT training?  
Any previous F.D. or E.M.T. experience?
Accidents or moving violations in the last 5 years?
Best times to contact you:

  
 
 



 
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