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Home
About Us
Chief’s Corner
Board of Directors
Board Meeting & Minutes
Budget
Meetings & Agendas
Newsletters
Apparatus
Members
Call Statistics
News
Chain of Command
Fire Corps
SOCO Wildland
SOCO Wildland Firefighter Program
SOCO Personnel – Stramoor Hills
SOCO – Hanover Personnel
SOCO – Security Fire Personnel
MFP
Master Firefighter Program
Master Firefighter Testimonials
Safety Corner
Fire Prevention
Fire Inspections
Building Permits
Red Flag Warning and Fire Restrictions
Disaster Preparedness
Links
Contact Us
Join Us
Stratmoor Hills Fire Department Volunteer Application
Application
First Name
*
Middle
Last Name
*
Today's Date
*
Email
*
Address
*
Address
Address
Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Daytime Phone
Evening Phone
Due to Insurance Requirements – are you at least 18 years old?
*
Yes
No
Can you read and write English
Yes
No
Drivers Lisence
*
Yes
No
License #
State
Type
Exp. Date
Has it ever been revoked or suspended
Yes
No
Explanation
Do you own or have access to a reliable vehicle
*
Yes
No
Is the vehicle insured
*
Yes
No
Have you had any D.U.I.’s in the past 5 years
*
Yes
No
Have you ever had a felony conviction?
*
Yes
No
Do you have a high school diploma or G.E.D. ?
*
Yes
No
Do you have a current Colorado E.M.T. certification?
*
Yes
No
Have you received your Hep-B vaccination
*
Yes
No
Date completed?
Do you have any current Colorado firefighter certifications?
*
Yes
No
Please list certifications and expiration dates
List any other emergency services certifications or education you may have
Upload Your Dertificate
Drop a file here or click to upload
Choose File
Maximum file size: 268.44MB
Upload Your Dertificate
Drop a file here or click to upload
Choose File
Maximum file size: 268.44MB
Upload Your Dertificate
Drop a file here or click to upload
Choose File
Maximum file size: 268.44MB
Upload Your Dertificate
Drop a file here or click to upload
Choose File
Maximum file size: 268.44MB
List any other knowledge or skills you think would pertain to you position
Employment History
Current Employer
Supervisor
Address
Address
Address
Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Phone Number
Dates Employed from
to
May we contact this employer?
Yes
No
Previous Employer
Supervisor
Phone Number
Dates Employed from
to
May we contact this employer?
Yes
No
References:
Please provide us with two (2) references. One personal and one professional.
Reference 1: Personal
Name
Relationship
Phone
Email
Years known:
Reference 2: Professional
Name
Relationship
Phone
Email
Years known
Health and Medical History
Have you ever consulted a physician or health service practitioner for treatment concerning any of the following?
Allergies
*
Yes
No
Back Pain
*
Yes
No
Blood Pressure
*
Yes
No
Cardiovascular disease
*
Yes
No
Diabetes
*
Yes
No
Dizzy spells
*
Yes
No
Ears
*
Yes
No
Epilepsy
*
Yes
No
Eyes
*
Yes
No
Fractures
*
Yes
No
Headaches
*
Yes
No
Nervous System
*
Yes
No
Orthopedic
*
Yes
No
Respiratory Problems
*
Yes
No
Tuberculosis
*
Yes
No
Tumors
*
Yes
No
Ulcers
*
Yes
No
Urinary Tract Problems
*
Yes
No
If you answered yes to any of the above conditions, please list the condition, type of treatment and date of treatment
Please explain briefly your interest in becoming a member of the Stratmoor Hills Volunteer Fire Department
Signature
*
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Date
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