White Marsh Application for FIRE, EMS OR SUPPORT SERVICES

First Name*

Middle Initial

Last Name*

Email*

Address*

(Please include city, state, ZIP - ex. 10331 Philadelphia Rd., White Marsh, MD 21162)

Phone number*

Phone

DOB*

What is your highest level of education?*

Select

If you have a resume, please upload it here.

Drag and drop files here or

Which of the following do you wish to primarily puruse?*

FIRE

EMS

ADMIN

REHAB

Which of the following applies to you?*

Select or enter value

If you have a personal recommendation from an active WMVFC member, please list their name and phone number.

Are you CURRENTLY a member of:*

Baltimore County (Career) Fire Department

Another volunteer fire department in Baltimore County

A career or volunteer fire department outside of Baltimore County

None of the Above

If your answer to the previous question was anything besides "None of the above," please specify the organization(s) below. If you are a BCoFD member, please list your station and shift.

If you are, or previously were a member of a Baltimore County Career or Volunteer station, provide your LOSAP or Identification number.

If you are leaving your current volunteer fire company, or if you were previously a member at one, please list your reason for leaving.

Why are you interested in participating in the emergency services field?*

Why are you interested in becoming a member of the White Marsh Volunteer Fire Company versus becoming a member of another volunteer station in Baltimore County? Simply being close to home (by itself) is not a sufficient answer.*

What are you short term and long term goals with WMVFC?*

Have you ever been rejected, suspended, or expelled from any volunteer fire, rescue, or EMS department?*

Yes

No

If you answered yes to the previous question, please explain.

Are any of your certifications or licenses (including EMT licenses and driver's licenses) currently suspended, were previously suspended, or currently pending an investigation?*

Yes

No

By signing this form, I acknowledge that all information contained within this application is correct and accurate to the best of my abilities. I understand that omission of facts or misrepresentations may nullify my application.*

Please print your full name

(Under 18) Applicants who are under the age of 18 must have a parent/guardian signature and phone number.

Please print the name and phone number of the parent/guardian below

Send me a copy of my responses