HFD Membership Application

HFD Membership Application
Your Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Time at Address
(years)
Do you own or rent?

Other
Cell Phone

Area CodePhone Number
Home Phone

Area CodePhone Number
E-mail
Best Time to Reach You
Are you 18 or older?

Educational Background
School/Location
Degree
School/Location
Degree
School/Location
Degree
School/Location
Degree
List any honors. awards or publications

Work/Professional Experience
Employer
From-To
Position/Title
Duties/Responsibilities
Employer
From-To
Position/Title
Duties/Responsibilities
Employer
From-To
Position/Title
Duties/Responsibilities
Additional Comments

Volunteer/Community Service Experience
Organization
From-To
Duties/Responsibilities
Organization
From-To
Duties/Responsibilities
Organization
From-To
Duties/Responsibilities
Additional Comments

Availability Information
Planned/Regular Department Activities take place on Monday Evenings. This includes training, truck checks and business meetings. Does your schedule allow for you to regularly attend activities on Monday evenings?
Describe Limitations to Monday Night Activities
Responding to calls for emergency services happen on a 24 hour a day, 7 day a week basis. Being a volunteer/Paid-On-Call organization, having an understanding of member availability during general timeframes is helpful.

Please describe you general availability during the following blocks of time
Weekdays: Mon-Fri 8am-5pm
Weekdays: Mon-Fri 5pm-8am
Weekends: Sat-Sun
Please add any information that would help in evaluating your general availability

Summary
Why are you interested in becoming involved with the Hamel Fire Department?
How did you find out about is (check all that apply)
Should be Empty: