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12535 Old Frederick Rd
Sykesville, MD 21784
 
Emergency Dial 911
Station 3: 410-313-5403
E-mail: info@wfvfd.org


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Probationary Membership Application

West Friendship Volunteer Fire Department, Inc.
P.O. Box 439
12535 Old Frederick Road
West Friendship, MD 21794
410-313-5403

This application is subject to a six (6) month probationary period after acceptance to the department.

THIS FORM MUST BE SUBMITTED WITH A COPY OF YOUR SOCIAL SECURITY CARD AND DRIVERS LICENSE. A WORK PERMIT MUST ALSO BE SUBMITTED IF YOU ARE UNDER THE AGE OF 18.

Required   Indicates Required Field
Membership Type: Required
Area of Interest: Required
Name: Required
Current Address: Required
How long have you lived at this address: Required
Email Address: Required
Home Phone Number:
Cell Phone Number:
Date of Birth:
Social Security Number:
Driver’s License Number:
Driver’s License State Issued:
Employer Name:
Work Phone Number:
Employer Address:
Occupation:
Have you ever been convicted of any violation of the law, other than minor traffic violations: Required
If Have you ever been convicted of any violation of the law, other than minor traffic violations please explain:
Your physical condition (please note any impairments):
Have you ever made application or been a member of another fire department: Required
If you have been a member of another department, where:
If you were a member of another fire department, specify type: Paid
Volunteer
HoCo EID #:
(If Applicable)
Provide three character references not related to you
Reference #1:
Name, Address, Phone Number, Relationship
Required
Reference #2:
Name, Address, Phone Number, Relationship
Required
Reference #3:
Name, Address, Phone Number, Relationship
Required
Please Submit copy of your Drivers License and Social Security Card (Under 18 please also submit work permit): Required
Add files...
If elected to membership, I will support the Constitution, adhere to the Bylaws, and obey all rules and regulations of the WFVFD.
I will also avail myself of the necessary FIRE/EMS training courses to become a fully competent member. Once I am able to ride apparatus, I acknowledge that I will be expected to participate on a duty crew.
I also acknowledge that all statements made in this application are true and correct to the best of my knowledge, and I approve the use of the information provided in this application to conduct a complete background investigation.
Electronic Signature of Applicant: Required
Signature of Parent or Guardian (If Applicant Is Under 18):
Submitted: 08/15/2022 1700




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West Friendship Volunteer Fire Department
P.O. Box 439
West Friendship, MD 21794-0439
Emergency Dial 911
Station 3: 410-313-5403
E-mail: info@wfvfd.org
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