EmailMeForm
MCFC Advocate Volunteer Form
Name
*
First
MI
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Email
*
Phone
*
###
-
###
-
####
Phone Carier
Example At&t, Verizon, T-Mobile, etc....
Please upload a image of yourself
This will be for your ID badge
Date of Birth
*
MM
/
DD
/
YYYY
In Case of an emergency
Please enter your emergency contact information
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Primary Phone
*
###
-
###
-
####
Secondry Phone
###
-
###
-
####
Email
*
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Do you have Reliable Transportation?
*
Yes
No
What is your Facebook link?
Example. htp://www.facebook.com/whatever
What is your shirt Size?
Small
Medium
Large
X-Large
2XL
3XL
4XL
5XL
Have you been convicted of a felony?
*
Yes
No
If so what was it?
Are you willing to submit to a background check?
*
Yes
No
Drivers License Inforatmion
Driver’s License Number
*
State:
*
Class
*
Expiration Date
*
MM
/
DD
/
YYYY
Ways you can help
Are you over 18?
*
Yes
No
Is there a specific job or area you might be interested in?
(Please check all that apply)
Administrative
Rehab
Grant Writing
Disaster Division
Maintenance (Veh.)
Chaplain
Search and Rescue
Fundraising
Weather Spotting
Communications
Not Sure
Is there a specific job or area you might be interested in? (Under 18)
(Please check all that apply)
JR Fire Corp
Not Sure
Other possible areas you might like to work in?
What is your availability for “Call-Outs”
Do you have a amateur (ham) license)
*
Yes
No
Will you be willing to certify for your amateur radio license in the fir 6 months?
*
Yes
No
Any Special Skills & Past Volunteer Experiences, training and certifications
By Checking this box you acknowledged all expenses for deployment to call outs and meetings and equipment will not be compensated.
*
MCFC strictly follows general code of rules. By checking this box you are in agreement to follow General code of Rules.
*
Signature
*
Clear
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in volunteering with us.
