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?*

OwnRentOther
Cell Phone*

Area CodePhone Number
Home Phone

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

YesNo

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?*

YesNo
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: