Please fill out the department online application. Once completed it will be submitted to the membership committee for review. You will be contacted once reviewed and will be relayed the status of your application.
Thank you considering becoming a member of the Solomons Volunteer Rescue Squad and Fire Department. We look forward to meeting you and becoming part of our family. ~The Solomons Volunteers
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| Applicant Information |
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| Last Name:
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| First Name:
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| Middle Name:
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| Mailing Address:
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| City:
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| Zip Code:
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| Date of Birth:
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Social Security Number:
If you prefer to not fill out your SSN then a member of the recruitment team will contact you for the information.
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| Phone Number:
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| Email Address:
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| State and Class of Drivers License:
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| Drivers License Number:
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| Work/School Information |
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| Occupation:
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| Place of Employment:
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| Name of School (If applicable):
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Medical Conditions:
Do you have any current medical or physical conditions which may limit your participation in department activities? If, None please put N/A
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| Emergency Contact and Relationship:
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| Emergency Contact Phone Number:
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| Physician:
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| Physician Phone Number:
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| Emergency Response Experience |
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Emergency Experience:
Do you have any experience in the emergency response field to include firefighting, EMS, or rescue. If so explain. If none, please put N/A
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Training Obtained:
If none, please put N/A
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Certifications:
If none, please put N/A
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| Criminal Information |
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Criminal Info.:
Have you ever been convicted of a crime other than a misdemeanor? If so please explain. If none, please put N/A
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| References |
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Applicant References:
Provide three (3) references, not related to you. Please provide a name, address and phone number for all three.
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| Application Certification |
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Application Signature:
I certify that all statements are true. I understand that any false statements made will be grounds for rejection or dismissal. I agree to abide by the By-Laws and rules of the Solomons Volunteer Rescue Squad and Fire Department.
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Parent or Guardian Signature:
Signature of Parent or Guardian (If applicant is under 18). Upon applicant review the Parent or Guardian will be contacted for verification of signature.
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| Submission Date:
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07/13/2020 1415 |
Please read Carefully By submitting this application for membership in the Solomons Volunteer Rescue Squad and Fire Department (SVRSFD), I authorize investigation of all statements contained therein. I hereby authorize SVRSFD to make any contacts considered necessary for me to become a member, such as current employers, criminal records, etc. It is understood and agreed that any misrepresentation by me in this application, will be sufficient cause for cancellation of the application or for separation from SVRSFD as a member at any time. I understand that this application is the property of Solomons Volunteer Rescue Squad and Fire Department and will become part of my personnel file if I am accepted as a member. POLICY STATEMENT: SVRSFD is an equal opportunity organization and shall not discriminate against any member or applicant due to age, sex, marital status, national origin, religion, race, physical or mental handicap unrelated to the performance of the job or any other prohibited reasons. The Membership Committee will review this application and additional information developed during background checks. Applicants may be disqualified for criminal conduct. If applicant is less than 18 years of age, a parent or legal guardian MUST submit this application.
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