Shawswick Volunteer Fire Department
Application For Membership

Name:__________________________     Phone: (____)_____-_____________

Address:________________________________________________________

Date of Birth: Month:____________  Day:______  Year:__________  Age:_____

Married:  Yes_____  No____    Number of Dependents_____

Do You Have Any Previous Fire Fighting Experience?  Yes____  No____

If Yes Explain:___________________________________________________

Do You Hold A Valid Drivers License?   Yes_______  No______

If No Please Explain:______________________________________________

Are You Afraid Of Fire?  Yes___  No___   Are You Able To Work On A Ladder Or Roof? 
Yes____ No____

What Shift Do You Work? 1st__2nd__3rd__ What Time Would You Be Available? 
                                                                        From______To______

Will You Attend All Business Meetings And Training Meetings? Yes_____  No______

Do You Agree To Take The Mandatory 24 Hour Training As Well As Yearly Blood Bourne Pathogen
And CPR? (All Will Be Provided By The Fire Department At No Cost To You.) 
Yes_______  No______

I Certify That The Above Answers Are True To The Best Of My Knowledge, And Further Certify That
No Promise Of Pay, Money Or Any Other Consideration Has Been Made To Me And That I Fully
Understand That Service In The Shawswick Volunteer Fire Department Is Entirely On Voluntary And
Non Paid Basis.

______________________________        __________________________      _______________________
         Signature of Applicant                                  Name of Proposer                            Name of Chief       

1st Reading:                                          Screening Committee:                                2nd Reading:
Approved: Yes___ No___                Approved: Yes___ No___                        Approved: Yes___ No___
Date__________                                Date___________                                     Date of Entry__________       HOME