EmailMeForm
Volunteer Membership Application
Metro Richmond Flying Squad Inc.
Date Application Submitted
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/
DD
/
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Name
First
Last
Address
*
City
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Zip
*
Email
*
Cell Phone
*
Have you ever been convicted of a felony
*
Yes
No
If yes, please explain why:
Current Employer, if retired enter RETIRED
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Your position
Supervisor's name
Supervisor's telephone number
Do you currently have a smart phone ?
Please select
yes
no
Have you ever been involved in any of the organizations below? Click all that apply.
PAID FIREFIGHTER
VOLUNTEER FIREFIGHTER
RESCUE SQUAD MEMEBR
BOTH PAID AND VOLUNTEER FIREFIGHTER
OTHER VOLUNTEER ORGANIZATIONS
If so, list name and location of each agency.
If you have had experience with any of the agencies above, please describe your duties. If you are no longer with them, please advise why.
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Please tell us a little about yourself and why you feel you would be an asset to the Metro Richmond Flying Squad.
*
How did you hear about the Metro Richmond Flying Squad?
*
Please select
Facebook
Word of mouth
From a friend or co-worker
Current member
Other
Emergency Contact
First
Last
Phone
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###
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####
Emergency Contact Address
City, State, Zip Code
2 Letters of Recommendation
Add File
Please provide 2 letters of recommendation
Checkbox
*
By checking this box I understand that I am required to staff In station 20 hours a month
DISCLOSURE FOR CONSUMER REPORTS
In connection with my application for employment (including contract or volunteer services) with Metro Richmond Flying Squad Inc., I understand consumer reports will be requested by you (“Company”). These reports may include, as allowed by law, the following types of information, as applicable: names and dates of previous employers, reason for termination of employment, work experience, reasons for termination of tenancy, former landlords, education, accidents, etc. I further understand that such reports may contain public record information such as, but not limited to: my driving record, workers’ compensation claims, criminal records, etc., from federal, state, and other agencies that maintain such records.
In addition, investigative consumer reports (gathered from personal interviews, as applicable, with former employers or landlords, past or current neighbors and associates of mine, etc.) to gather information regarding my work or tenant performance, character, general reputation and personal characteristics, and mode of living (lifestyle) may be obtained.
If I am offered a volunteer position, I understand that my employer can use this disclosure and authorization to continue to obtain such consumer reports throughout my employment, contract period or volunteer service.
Please type your name in the field below as an electronic signature
Number
