Membership Application

//Membership Application
Membership Application 2017-02-06T11:05:59+00:00
The Fortuna Volunteer Fire Department is always seeking qualified candidates to join the team. Are you interested? Complete the form below and your application will be emailed to the fire department. We will get in touch with you to begin the process. Thanks for applying!

Membership Application Fortuna Volunteer Fire Department

This form is to be completed by the Applicant in its entirety and submitted (see submit button at bottom of application) to the Fire District Secretary. Applicants must be 18 years of age and reside within the Fortuna Fire District boundaries (not applicable to Resident and Intern Volunteers) which include the areas of Alton, Hydesville, Palmer Creek, Fernbridge and Fortuna. Once accepted as a proposed member, applicant will be required to have a physical exam which includes a pre-employment drug screen performed by an appointed Fire Department Doctor as well as a live scan (background check), both will be at the expense of the Fire District.

In submitting the membership application form, the Applicant acknowledges that their employer and spouse or partner is aware that if the Applicant is accepted for membership in the Fortuna Volunteer Fire Department, he/she will be giving part of their time to public service, and that they support this commitment and involvement. Applicant realizes that the Fortuna Volunteer Fire Department is not a social club and that as a member they will be required to give freely of their time to attend fire/rescue calls, training drills, meetings and work on committees.

Applying For

Volunteer FirefighterResident Volunteer FirefighterIntern Volunteer Firefighter

About You

Education

Education Name and Location Diploma/Degree/GED
High School
College
Other

Background

Have you been convicted of a crime, other than a minor traffic violation?

NoYes

Employment History

Provide information on present and former employers for the past 4 years beginning with the most recent.

May we contact? YesNo
 
May we contact? YesNo
 
May we contact? YesNo

Experience

References

List 3 references giving complete names, address, phone and number of years known.

 
 

Emergency Contact

Motivation

Certification

By checking the box below I certify that, to the best of my knowledge and belief, the answers given by me to the foregoing questions, the statements made by me in this application, and any attached documentation provided by me are correct and complete. I understand that misrepresentation or omission of facts may lead to disqualification of eligibility.

Volunteer Firefighter Position

This section to be completed only by those applying for a Volunteer Firefighter Position. Applicant must be 18 years of age and reside with-in the Fortuna Fire Protection District boundaries.

Please list the hours of the day/night you are available to respond.
 
I realize that if is accepted for membership in the Fortuna Volunteer Fire Department, he/she will be giving part of their time to public service. I support this commitment and involvement and hereby give
my consent.