Red Feather Lakes Volunteer Fire Department
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Application Instructions
Prior to filling out the application, please read the Bylaws, policies, and job descriptions located in the Bylaws section of this website. Fill out the application completely. If you need help with any part of the application, contact a member of the department. Every effort will be made to assist you promptly. If more space is needed to complete any question, use the comment section at the end of the form.
If you prefer you may print this form using your browser's print command, fill in the answers by hand, then mail it to the address in the heading above. Or, if you wish to print a copy of the form with your answers in place, do so before clicking the submit button.
Thank you for your interest in joining the Red Feather Lakes Volunteer Fire Department.
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Indicates required field
Name
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First
Last
Email
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Address
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Phone Number
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Date of Birth
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Social Security Number
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Choose Membership Category You are Applying For
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Full Duty Firefighter
Limited Duty Firefighter
Part Time/Seasonal Firefighter
Station Logistics Technician
Do You Have a Current Driver's License?
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Yes
No
License Number, State of Issue, Date of Expiration
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Have you ever had any moving violations?
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Yes
No
If 'Yes' please explain
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Has your driver's license ever been suspended or revoked?
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Yes
No
Have you ever been convicted of driving under the influence?
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Yes
No
Have you ever been convicted of a felony?
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Yes
No
Note: A background check may be conducted at department discretion
Do you have any physical limitations?
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Yes
No
If 'Yes' please explain:
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Most Recent Employment
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Please include employer's address and phone number, your job title and duties, and your supervisor's name.
Are you currently working for this employer?
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Yes
No
List two references
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Please include names, contact information, and relationships.
Emergency Notification
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Please provide relationship and contact information for a person to be notified in case of emergency.
Motivation
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Please write a brief narrative explaining why you wish to join the Red Feather Lakes Volunteer Fire Department and what strengths and experience you bring to the organization.
Medical Review Part 1 - Have you ever...
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Had a hernia or rupture?
Been a patient in a sanitarium or institution?
Been tested for a nervous disorder?
Been seriously injured?
Been refused employment for health reasons?
Been rejected/discharged from military service for health reasons?
Received Workers'Compensation?
Received a pension or disability?
Been refused life insurance?
Been made ill by your work?
Been refused a driver's license for health reasons?
Used a hearing aid?
Had seizures or convulsions?
Injured your back?
Had a head injury?
Been treated with radiation?
Taken any medications regularly?
Lost over two weeks of work due to illness?
Please check all that apply. The medical form must be complete and accurate. All information is considered personal and confidential in nature and will be treated as such by handling it in strict compliance with the Americans with Disabilities Act.
Medical Review Part 2 - Do you currently have...
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Diabetes?
High blood pressure?
Tuberculosis?
Depression?
Heart trouble?
Cancer?
Arthritis?
Epilepsy?
Allergies or reactions to medication?
Athsma?
Blood in urine?
Cough?
Fainting spells or dizziness?
Hay fever?
Frequent headaches
Jaundice?
Joint Pains?
Paralysis?
Rheumatic fever?
Shortness of breath?
Skin rashes or eczema?
Stomach ulcer?
Varicose veins?
Other Medical Issues
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If there are any emergency instructions, conditions, needs or procedures that the department should know about, please explain them here:
Comment
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If you have any additional comments or questions, please include them here.
Certification and Release
I certify that the information given by me in the foregoing answers, and the statements made by me, are complete and true to the best of my knowledge and belief. I acknowledge that I have read the Bylaws and policies, and agree to abide by those said documents. I understand that any false information, omissions, or misrepresentation of facts in the application may result in rejection of my application or discharge of my membership. I hereby affirm that the information on the Medical Review Form is true and correct and that there are no omissions. I also state that I have the mental stability to perform under stress as a member of the Red Feather Lakes Volunteer Fire Department.
Name
*
Date
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Submit
Home
Reverse Emergency Alerts
District
Board of Directors
Board Meeting Minutes
Legal Notices
Resolutions
Budget
Department
Insurance FAQ
Bylaws
Firefighters
How to Become a Firefighter
Wildfire
Evacuation Routes
Can You Stay?
Are You Fire-Ready?
Health & Safety After Fire
Insurance Tips
County Fire-Flood Status
Donate
Contact Us
Photos
Videos
Air Link
Calendar
Photos
2011 Photos