HFD Membership Application

HFD Membership Application
Your Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Time at Address
(years)
Cell Phone *

- Area Code Phone Number
Home Phone

- Area Code Phone Number
E-mail *
Are you 18 or older? *

Yes No
Best Time to Reach You

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? *

Yes No
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: