CFR Application

COROLLA FIRE & RESCUE SQUAD, INC.

INFORMATION FOR APPLICANTS

Membership Criteria

PRINT and FILL OUT Application and Top Part of Personnel File Info completely; DELIVER TO Station 6,  Whalehead! We’ll introduce you at our next meeting…

The State of North Carolina mandates a fire department must maintain 20 current, active members on their annual roster. To be eligible to be on the roster, a member must complete 36 hours of training each fiscal year (July 1 – June 30). This total of 36 hours can be a combination of Training and Business meetings. A specific total of 18 hours of Training is required to maintain Active Member status.

The following are categories of Membership Status:

New Un-Trained Members:

A new member must attend meetings for a 90 day period. After this time the new member will be eligible to receive equipment, e.g., pager, from Corolla Fire & Rescue. If the new member does not live in the response area, the member must be willing to respond to all calls during the day. After 18 hours of approved training are completed by the new member, he/she will receive turn-out gear and other related equipment. The 18 hours of training must be completed within a six (6) month period or membership with Corolla Fire & Rescue. Training may be scheduled with the Fire Chief or Training Officer. The applicant can achieve the required 18 hours of training through Training meetings or scheduled sessions with the Fire Chief or Training Officer. Training can also be accomplished elsewhere, but must meet with the approval of the Fire Chief. To maintain a current, active membership status, a member must complete 36 hours of Business & Training meetings each year.

New Trained Members:

Upon presentation of authorized certification of training, time and training requirements for a new member may be waived to receive a pager. The New Trained Member must attend Business and Training meetings for a 90 day period and accomplish 18 hours of training within a six (6) month period to receive related equipment from Corolla Fire & Rescue.

Individual membership cases may be reviewed by the Fire Chief for special consideration.

If current, active membership status is not maintained, all gear and related equipment must be returned within seven (7) days of notification by the Fire Chief.

I have read and understand the Membership Criteria for Corolla Fire & Rescue Squad, Inc. I further understand that I am responsible for all gear and related equipment that is issued to me during the course of my membership and agree to return same should I fail to meet active membership requirements during the prescribed periods.

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Applicant Signature                                                                                   Date

________________________________________________                  _________/_________/__________

Authorized Signature/Membership                                                            Date

Approval

Corolla Fire & Rescue Squad, Inc.

COROLLA FIRE & RESCUE SQUAD, INC.

APPLICATION FOR MEMBERSHIP

_______________________________________        _________/___________/___________

Full Name                                                                      Date of Birth

_______________________________________        _______________________________

Street Address                                                              Social Security Number

_______________________________________        _(_______)_______________________

City/ State/ ZIP                                                              Phone

Do you have any know physical handicaps? _______

If YES, please describe: _______________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Please check all that apply. I am willing to participate in the following:

Training Functions       __________               Fund- Raising Activities    __________

Business Meetings      __________               Serve on Committees       __________

Clean Fire Trucks        __________               Clean Ambulances           __________

Building Clean-Up       __________               Yard/Property Up-keep     __________

EMS Call Response    __________               Fire Call Response           __________

I, the undersigned applicant, have reviewed and understand the “Information for Applicants” statement which outlines the membership criteria of Corolla Fire & Rescue Squad, Inc. I agree to conform to the membership criteria for the duration of my membership.

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Signature of Applicant                                                                               Date of Application