Midway Volunteer Fire Co.

About Us

History

Stations

Honor Guard

Auxiliary

Fire Police

Firefighter of the Year

FAQ

Fire Prevention

News

Phillyfirenews.com

Bucks County Fire

Firehouse.com

Fund Raising

Fund Drive

Carnival

Car Raffle

On The Job

Past Events

Apparatus

Application for Active Service

Please complete and submit the requested information.

No prior firefighting experience is required. All training and equipment will be provided.

Once your completed application has been received, the membership committee will complete a background check and schedule an interview with you. After your interview and background check have been completed the membership committee will make a recommendation to the company whether or not to accept your application. A vote by the membership to accept you as a probationary firefighter and member of the fire company will then take place at the next scheduled monthly business meeting.

Personal Information

Name:

Social Security Number:

Present Address:

How long have you lived at your present address?

yrs.

Previous Address:

How long did you live at the previous address?

yrs.

Date of Birth:

Home Phone Number:

Cell Phone Number:

Pager Number:

E-mail Address:

Drivers License Number:

State:

Have you ever been convicted of a crime?

YES NO

If YES, please explain:

Do you have any previous firefighting and or rescue experience?

YES NO

If yes, please fill out the information requested below.

Fire Company/ Department:

Address:

Contact:

Phone Number:

Fire Company/ Department:

Address:

Contact:

Phone Number:

Please check any courses that you have completed.

Firefighter 1	Hazmat First Responder
Firefighter 2	Hazmat Operations
Basic Vehicle Rescue	Hazmat Technician
Advanced Vehicle Rescue	FAST/ RIT Team Training
EVOC/ Driver Training	Officer 1
Pump 1	Officer 2
Pump 2	Officer 3

Did you hold any executive office or line officer positions? If yes, please list:

Position: Number of years:

Education

College:
Number of years attended:
Technical School :
Number of years attended:
High School:
Number of years attended:

Employment

Company:
Years employed:
Position:
Address :
Phone:
Type of business:

Company:
Years employed:
Position:
Address :
Phone:
Type of business:

Company:
Years employed:
Position:
Address :
Phone:
Type of business:

Company:
Years employed:
Position:
Address :
Phone:
Type of business:

Personal References

(not former employers or realatives)
Name:
Address :
Phone Number:
Occupation:

Name:
Address :
Phone Number:
Occupation:

Name:
Address :
Phone Number:
Occupation:

Name:
Address :
Phone Number:
Occupation:

Statement of Understandings and Authorizations

I hereby apply for membership in the Midway Volunteer Fire Company (hereinafter know as the Company) and, if accepted for membership, I will comply with the constitution, bylaws, rules, standard operating guidelines, and the conduct expected of company members.

I authorize the Company to investigate the statements made in this application, I understand that an investigation of these statements may be made, including but not limited to, a criminal background check and a Bureau of Motor Vehicles records check. I understand that omitting or falsifying information in this application or any subsequent interview connected with this application ma result in denial of membership or expulsion from the Company.

I hereby authorize the following parties to release any and all information concerning me to the Officers of the Company and their agent:

1. Bureau of Motor Vehicles of the Commonwealth of Pennsylvania, or any other state driver’s license authority;
2. Any Law Enforcement Agency;
3. Any emergency services agency I was ever a member of;
4. Any employer, past or present.

In case of emergency call 911!

Midway Volunteer Fire Company Annual Carnival!

Car Raffle

All words and pictures in this site are property of the Midway Volunteer Fire Company located in Lahaska PA. Unless otherwise indicated, no reuse in print or web format is permitted without express permission from Midway VFC ©2005 All Rights Reserved