Sykesville Freedom District Fire

Junior Application

Sykesville-Freedom District Fire Department
Junior Firefighter Program

Required   Indicates Required Field
PERSONAL
Membership Type: Required
Name: Required
E-mail Address: Required
Address: Required
How long have you lived at this address?: Required
Home Phone:
Business Phone:
Sex:
Where are you currently employed?: Required
If you were in the Armed Forces, when were you discharged? Month/Year:
Are you under 16 years of age?: Required
Date of Birth: Required
Have you ever been convicted of a traffic violation, misdemeanor, or a felony?: Required
If Yes, indicate the date and nature of the charge, police agency, court and disposition.:
EXPERIENCE
Have you ever filed an application with Sykesville Freedom District Fire Department?: Required
If so, when?:
Have you ever been denied membership to a fire and/or rescue squad?:
If so, please give details.:
Have you ever been discharged for misconduct or unsatisfactory service or asked to resign from a fire and/or rescue department?: Required
If you have been discharged please give details.:
List any firefighting and/or emergency medical certifications that are current. Please provide copies of certifications:
Upload Certifications:
Add files...
EDUCATION
Middle or High School attended:
REFERENCES
Reference #1: Required
Reference #2: Required
Reference #3: Required
EMERGENCY CONTACT
Contact Name: Required
Contact Relationship: Required
Contact Address: Required
Contact Phone Number: Required
ACKNOWLEDGEMENT
Electronic Signature: Required
How did you hear about us?:

By signing above, I signify that I have applied for the membership to the Sykesville Freedom District Fire Department; that I have answered all questions truthfully and to the best of my knowledge; and that I fully understand that any intentional false statement may be grounds for dismissal from the department. Furthermore, I hereby grant to Sykesville Freedom District Fire Department permission to contact my employer, references, and any other persons or agencies who may have knowledge of me, my skills and my experience as may be deemed necessary.

 





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Sykesville Freedom District Fire Department
6680 Sykesville Road
Sykesville, Maryland 21784
Emergency Dial 911
Non-Emergency: 410-795-9311
E-mail: info@sykesvillefire.org
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