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Fire Corps Application

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First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Home Phone*
(XXX)XXX-XXXX
Cell Phone*
(XXX)XXX-XXXX
Email Address*
Date of Submission*
Date of Submission
Date of Submission
During which times are you available for volunteer assignments?
1. Weekday mornings
2. Weekday afternoons
3. Weekday nights
4. Weekend mornings
5. Weekend afternoons
6. Weekend nights
Check all that apply.
Which areas are you interested in volunteering?
1. Administration
2. Incident rehab
3. Public education
4. Other
Check all that apply.
Summarize any special skills and qualifications you have that may benefit the Department.
Summarize any previous volunteer experience.
Emergency Contact*
Address1*
Address2
City*
State*
Zip*
Home Phone*
(XXX)XXX-XXXX
Cell Phone*
(XXX)XXX-XXXX
Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age or disibility.
Thank You
Thank you for completing this application form and for your interest in the Fishers Department of Fire and Emergency's Fire Corp. Program.