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Application Instructions
- Highlight the entire application below
- Copy it to your clipboard
- Paste it to the "Information" box below (or you can copy it to microsoft word and paste it when completed)
- Completely fill out the application:
- Leave the Signature, Date and Date accepted blank we will have you sign a printed copy when you come in.
- Please fill in all the boxes, do not use the Tab key in the information box it will jump to the submit button.
- Click the submit button when finished
Note: You must attend a meeting before your application will be acted upon. If you email an application and do not attend the first available meeting it will be tabled until you do. Your 30 day observation period will begin at that time. You will be required to sign a copy of your application.
NAME:
ADDRESS: CITY/STATE/ZIP:
AGE:
PHONE#
DRIVERS LICENSE#
TYPE LICENSE:
HAVE YOU EVER BEEN A MEMBER OF THE FIRE DEPARTMENT BEFORE?
WHY DID YOU LEAVE AND WHEN: LIST ANY RELEVANT TRAINING YOU HAVE COMPLETED GIVE EXPIRATION DATES AND STATE IF OTHER THAN TN:
IF YOU HAVE NO TRAINING YOU MUST ATTEND TRAINING CLASSES AND BE CERTIFIED.
SPONSOR FOR MEMBERSHIP: DO YOU HAVE ANY HEALTH OR DISABILITY PROBLEMS?
HAVE YOU EVER BEEN ARRESTED OR CONVICTED OF A FELONY?
WHERE AND WHAT FOR?
IN CASE OF AN EMERGENCY WHO ARE WE TO NOTIFY?
LIST ANY ALLERGIES OR MEDICAL PROBLEMS:
LIST ANY MEDICINES YOU ARE ON:
LIST THREE ADULTS FOR REFERENCES, NO FAMILY, RELATIVES OR FIRE/RESCUE PERSONNEL
FROM DEPARTMENTS.
NAME:
ADDRESS:
PHONE:
NAME:
ADDRESS:
PHONE:
NAME:
ADDRESS:
PHONE:
PLEASE A BREIF SUMMARY OF WHY YOU WISH TO JOIN OUR ORGANIZATION:
THANK YOU.
HICKORY TREE FIRE DEPT. NAME_____________________________DATE____________
DATE ACCEPTED___________________________
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