What positions are you interested in? *

Check as many as you like!

Fire

EMS

Clerical Support

Equipment Maintainance

Fundraising

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Professional Reference *

First Name

Last Name

Professional Reference Phone *

(###)

###

####

Do you have a current Driver's License? *

Yes

No

Do you have a current EMT license? *

Yes

No

Please mark any trainings you have already completed:

Firefighter I

Firefighter II

Hazmat Training

Driver/Operator Equipment Training

EMT (Emergency Medical Technician)

EMR (Emergency Medical Responder)

ICS Training

Officer Developmental Training

Blue Card

Red Card

First Aid

CPR

Other

Are you willing to train on weekends or evenings? *

Yes

No