Please name two adults (not family members) who can provide a reference of your character:
In making application for membership in the Ligonier Volunteer Hose Company #1, I do hereby declare that should I become a member as a result of this application, I agree to uphold and abide by all the rules and regulations and by laws ofthe company. Futher, I swear that I will answer all alarms when able, and will attend to any duty to which I may be detailed by any officer in command. Further, I will attend all regular and special meetings, practices and schools as required. I will assist and cooperate to the best of my ability in all activities and on all committees of the fire company when called upon to do so by the proper authorities. Further, I will do all in my power to respect and protect all property of the fire company assigned and entrusted to me, and will, upon my termination as a member, return all property entrusted to me in good condition. In the event the equipment is not turned in during the period specified in the by laws, I will be liable for the cost of replacement. Failure to return such equipment to the Company may result in such property being declared stolen after five (5) business days. I understand the members of the fire company reserve the right to accept or reject any application for membership. I further understand that any violation or infraction of these declarations or the furnishing of false information in this application is reason enough to cause my application to be rejected, or my dismissal as a member of the Ligonier Volunteer Hose Company #1.
Having made an application for membership with the Ligonier Volunteer Hose Company #1, I understand that the Borough of Ligonier desires to obtain information concerning my background, education and character in order to better ascertain my qualification for such membership.
I hereby authorize the Borough of Ligonier and/or their agent/s on behalf of the Borough of Ligonier to investigate and ascertain any and all information concerning my background and character which may be pertinent to my qualification for membership. I understand that the information may be obtained from any person, document, or other source within or outside the Commonwealth of Pennsylvania.
I hereby release all persons and the Borough of Ligonier from any liability which might otherwise result from the release of said information to any authorized member of the Borough of Ligonier and/or their agent/s.
In consideration of this release, the Borough of Ligonier and their agent/s shall regard all information obtained as confidential. I understand the same shall not be released to any individual, including myself, or organization, absent good cause.
I agree that the Borough of Ligonier may admit this information into evidence in order to defend any administrative or court proceeding which is initiated on my behalf. I retain the right to challenge the accuracy of any such information in such a proceeding, but waive all objections as to the admissability of the information.
I understand I am not compelled to sign this authorization.
As parent/guardian, I have read and understand, as does my child, the above information concerning the release of background information as it pertains to his/her application.