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Volunteer Fire Company Membership Application

This field is for validation purposes and should be left unchanged.
If different in last two years

REFERENCES

Please provide three references (other than relatives or roommates) who can attest to your character or verify any statement made within this application.

Reference 1

Reference 2

Reference 3

EMPLOYMENT HISTORY

List your last two employers

Employer 1

Employer 2

EDUCATION

Tell us about your educational history

DRIVING / CRIMINAL / DISIPLINE HISTORY

In the past 5 years, have you received any moving violations/tickets, been involved in any auto-related accidents, or had your license suspended?
Have you ever been convicted of a crime other than a motor vehicle offense?
Have you ever been disciplined, suspended, removed, or dismissed from a Fire, Rescue, and/or EMS Service?
I understand as part of the membership review process and probationary period of the Fredon Volunteer Fire Company, routine criminal and motor vehicle background checks are made in order to preserve the integrity of the Company and ensure the safety and security of the lives and property entrusted to the Company. I hereby agree to have a criminal and motor vehicle background search performed by an official representative of the Fredon Volunteer Fire Company. I also understand that the results of these searches may be needed to complete my membership review and can affect my membership or probationary status.

MEDICAL HISTORY

Do you have allergies or outstanding medical, mental, emotional, or physical limitations that affect your ability to perform the tasks appointed to you?
Some tasks of the Fredon Volunteer Fire Company may involve strenuous activity. I give my consent to a doctor’s physical examination, provided by the Fredon Volunteer Fire Company, at no cost to me.
Check to consent to physical exam
Initial here

FIRE / RESCUE / EMS AFFILIATIONS

Are you currently, or have you ever been, a member of a Fire, Rescue, and/or EMS Service?
Do you have any training/certifications related to Fire, Rescue, and/or EMS?
I hereby state that the information I have provided in my application for membership to the Fredon Volunteer Fire Company is true and correct to the best of my knowledge. I understand that any misstatements or misrepresentations of myself or my credentials will be grounds for immediate review or dismissal by the membership committee. If accepted for membership, I agree to abide by the Constitution, Bylaws, and Guidelines set forth and promulgated by the Fredon Volunteer Fire Company.
First, Middle Initial, Last
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Signature

Hours:

Monday • Tuesday • Thursday • Friday
8 AM to 4 PM.

Closed Wednesdays

Summer Hours:

Memorial Day through Labor Day

Monday • Tuesday • Thursday
7 AM to 4 PM.
Friday
7 AM to Noon.

Address:

443 Rt. 94
Newton, NJ 07860
Google Map

Contact:

Phone: 973-383-7025
Contact Clerk

Township Committee

Land Use Board

Address:

443 Rt. 94
Newton, NJ 07860
Google Map

Contact:

Phone: 973-383-7025
Contact Clerk

Township Committee

Land Use Board

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