Membership Application Form

Name
Address
Date of Birth	Date of Residency in Bible Hill
Occupation	Business Phone
Place of Business	Home Phone
Hours of Work	Previous Fire Experience
Valid Driver’s License Yes ___ No ___	Category
Are you involved in an occupation which provides skills and/or training directly related to the Fire Brigade? (outline)
Have you had the required medical examination? Yes ___ (please attach copy) No ___
Are you willing to abide by the bylaws of the Brigade? Yes ___ No ___
Are you willing to attend drills, meetings, and fires regardless of time? Yes ___ No ___
Employer: I hereby agree that this application has been made with my knowledge and consent. Employer’s Signature:_______________________
Spouse: I agree that my spouse should join the Bible Hill Fire Brigade as a community service and hereby give my consent. Spouse’s Signature: ________________________
An application fee of $2.00 accompanies this application and, if accepted, I agree to pay the treasurer at the first meeting I attend, the sum of $2.00 as dues for the year.
Applicant’s Signature	Brigade Sponsor
Date of Application