Member Application

First name

Last name

Email

Phone

Current Address

City

Birthday

What are you interested in?

Experience

Current Occupation

Occupation Location

Tell us about your availability during the day, evenings and weekends

Tell us about yourself:

Tell us about any relevant current and/or past experience, training or certifications:

How do you prefer to be contacted should we need to follow-up on your application?

Willingness Statements:

Your application will be reviewed by department leadership, and if your application meets our criteria you will be contacted for an in person interview.

Are you willing to complete a criminal record check if successful?

Yes

No

Are you willing to provide a reference check if successful?

Yes

No

If successful, are you willing to complete at least 200 hours per year of required volunteer service hours (training hours are included)?

Yes

No

Do you have any current medical conditions, or are taking any medications that would restrict your ability to perform duties associated with firefighting

Option 1

Option 2

IN CASE OF EMERGENCY CALL 911

SERVING THE COMMUNITY SINCE 1979

MALAHAT FIRE RESCUE

Member Application

Experience

Willingness Statements: