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Membership Application

Required   Indicates Required Field
Demographic Information
Full legal name :
(as it appears on your driver’s license)
Required
Date of Birth: Required
Age: Required
Address:
Number, Street, Town/City, State, Zip Code
Required
Cell Phone:
Home Phone:
Email Address: Required
Drivers License Number:
(If applicable)
Driver's License Issuing State:
Driver License Class:
Employment History
Current Employer:
Position/Title:
Length of Employment:
Employer Address:
Employer Phone Number:
Fire Department/Emergency Service History
Are you now, or have you ever been a member of a volunteer fire or emergency service department?: Required No
Yes
Are you now, or have you ever been a member of a career fire or emergency service department: Required No
Yes
If you answered yes to any of the above, please fill out the following information:
Department Name, Position, Length of Service, Phone Number
Are you currently a certified firefighter: Required No
Yes
Are you currently a certified EMT (Emergency Medical Technician): Required No
Yes
If you answered yes to one or both of the above questions regarding firefighting and EMT certifications, please fill out the following information and attach certificates.
Fire Academy Attended:
Fire Academy Attended - State firefighter ID number - Level of Training
EMT Academy Attended:
EMT Academy Attended - State/National EMT ID number - Level of Training
Training Document Upload:
Add files...
Have you ever applied for membership with the Waretown Vol. Fire Company: Required No
Yes
If membership was denied in past, please state why:
Criminal History
Have you ever been arrested, convicted, or issued any summons for any criminal offense, DUI or Municipal Code Violations: Required No
Yes
If you answered yes to any of the above, please explain including type of offense:
Emergency Contact Information
Emergency Contact Name : Required
Emergency Contact Address: Required
Emergency Contact Phone Number(s): Required
Emergency Contact Relation: Required
File Upload:
NJ relief association application/medical paperwork signed by a doctor. - Any emergency responder certificates (ex. Fire 1 or EMT Certs.) - Copy of New Jersey Driver License.
Add files...
Acknowledgement
Electronic Signature of Applicant:
Please read information below before signing your electronic signature
Required

Attached is my application for membership with the Waretown Fire Company. I have given my full name, address, and other pertinent information as requested. I understand that this application must be completed in its entirety to receive consideration for membership.


I certify that I have carefully completed this application, and that I have given all information herein without omission or falsification. I further attest that no information has been withheld about my background.


I certify that I am least eighteen years of age; a legal resident of the United States; a resident of Waretown, New Jersey; hold a current New Jersey drivers’ license. Unless other wise noted as for Junior Members.


By signing my name to this letter, I consent to the investigation of all facts and circumstances given in the attached application for membership to the Waretown Fire Company. I also consent to the interview of any references provided herein, and to any background investigation needed by any law enforcement agency.


I fully understand that should any information herein be investigated and found to be false, I will be subject to dismissal from the Waretown Fire Company without recourse.


By signing Above, I also agree that should I become a member of the Waretown Fire Company, it is my responsibility to obtain copies of all governing by-laws and Standard Operating Guidelines. It is my responsibility to comply with these by-laws and guidelines. I understand that if I fail to comply with these by-laws and guidelines, I may face disciplinary actions and /or termination of my membership from the company.

Any juvenile applying for membership MUST have parental/guardian permission for the juvenile to be accepted at a Junior Member.
Any Junior Member will have requirements they must follow to maintain their membership.

  • Reporting of school grades twice a year (Half year and final).
  • Maintaining above a C average in school.
  • Nightly curfew at the fire house. No entering the firehouse or responding to emergencies during school hours or after 9 pm (on school nights).
  • Absolutely no illegal drugs or alcohol.

Parents/guardians must sign giving permission/consent for the Junior Member to become a member. They must also meet with the Fire Chief and Membership Committee after the completion of the application and prior to approval of membership.

Junior Member Permission Form

Please attach following paperwork with completed application.

  • NJ relief association application/medical paperwork signed by a doctor.
  • Any emergency responder certificates (ex. Fire 1 or EMT Certs.)
  • Copy of New Jersey Driver License.




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Waretown Volunteer Fire Co.
117 Wells Mills Road
PO Box 517
Waretown, NJ 08758
Contact Info:
Emergency Dial 911
Non-Emergency: (609) 693-3560
E-mail: info@waretownfire.org
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