Name

Date of Birth

Phone Number

Email

Address

Available Start Date

Preferred Shift

• Day

• Night

• Flexible/Any

Current/Most Recent Employer Name

Job Title

Employment Start Date

Employment End Date

Reason for Leaving

Previous Employer Name

Job Title

Employment Start Date

Employment End Date

Reason for Leaving

Do you hold any firefighting or emergency medical certifications?

If yes, please choose below:

• Firefighter I

• Firefighter II

• EMT Certification

• CPR/First Aid

Have you completed any fire safety training programs?

Do you have a valid driver’s license?

Are you able to lift and carry heavy equipment?

Are you comfortable working in high-stress environments?

Days Available to Volunteer

• Monday

• Tuesday

• Wednesday

• Thursday

• Friday

• Saturday

• Sunday

Available Hours

Specify available hours per day.

Reference #1 Name

Relationship

Relationship to Applicant

Phone Number

Email

Reference #2 Name

Relationship

Relationship to Applicant

Phone Number

Email

Have you ever been convicted of a crime?

If yes, please explain:

Provide details, if applicable.

Do you have any previous firefighting or military experience?

If yes, please specify branch and dates:

Why are you interested in volunteering as a firefighter?

Provide a brief answer.

Any Additional Notes or Special Requests

Specify any preferences or questions.

Upload File

Please attach relevant documents such as your CV or resume and certification files.