The Fire Departments of Enfield Application for Volunteer Membership

Each Fire Department is an EQUAL OPPORTUNITY EMPLOYER. State and Federal Law prohibit discrimination on the basis of race, color, religious creed, age, sex, marital status, national origin, ancestry, present or past history of mental disorder, mental retardation, physical or mental disability, sexual orientation, or veteran status, except in case of a bonafide occupational qualification law.

This application constitutes part of the examination process. It must be completed fully and accurately, even if a resume or other supporting materials are attached. Applications may be rejected or receive less consideration if answers are incomplete, vague or evasive. All statements are subject to investigation. Statements of fact found to be false, exaggerated or misleading may result in your disqualification.

Department for which you would like to volunteer:

Last Name: _____________________________________________________________

First Name, Ml.: _________________________________________________________

Date of Birth:   ___/___/____

Address:  ______________________________________________________________

              ______________________________________________________________

Telephone: _____________________________________________________________

E-mail: _____________________________________

Social Security Number: ____—___—____

Have you ever filed an application here before? ¢Yes   ¢No

If Yes, Give Date: :   ___/___/____

Educational Background

High School  ____________________________________________________

Location ______________________________________________________________

Course of Study ________________________________________________________

Did You Graduate?  ¢Yes   ¢No

Degree(s) Earned _______________________________________________________

College(s) ____________________________________________________________

                 ___________________________________________________________

Location  _____________________________________________________________

              ____________________________________________________________

Course of Study  ______________________________________________________

Did You Graduate?  ¢Yes   ¢No

Degree(s) Earned ______________________________________________________

Graduate School _______________________________________________

                           _________________________________________________

Location  ____________________________________________________________

              ____________________________________________________________

Course of Study  ______________________________________________________

Did You Graduate?  ¢Yes   ¢No

Degree(s) Earned ______________________________________________________

Specialized Training and Skills: List any special qualifications or experience not covered elsewhere in this application that you feel may qualify you for this position (i.e. seminars, special awards, professional memberships, licenses, etc).

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