Membership Application Form

You must be 18 or older to apply. If you are a college student, see if our Bunk-in Program is right for you.

Contact Information

This is for more room for your primary address, not for a second address

Personal Information

How long at current address
Are you a citizen of the United States? *
Do you have the legal right to remain permanently in the United States *
Have you ever been known by another name? *
(e.g. marriage)
Gender *
Do you wear glasses? *
Do you have a Driver's License? *

Availability

Indicate your availability to participate in normally required fire department activities (meetings, drills, and emergency calls).
Days
Evenings
Nights

Military Service

Have you served in the United States Armed Forces? *
Have you ever received disability or compensation benefits for any injury? *
Do you have any restrictions that might/will affect your ability to participate in fire department activities? *