Volunteer FF Application

Apply To Be A Volunteer Fire Fighter

NOTE: This application is for a volunteer position only and is not an application for a full-time, career fire fighter. Before filling out this application, you should confirm that you live within the Verdigris Fire Protection District. Applicants living outside the Verdigris Fire Department response area will not be considered. Thank you for your interest in volunteering for the Verdigris Fire Department.

Name :	Field not valid (required or bad value)
Address :	Field not valid (required or bad value)
SSN :	Field not valid (required or bad value)
Telephone Number :	Field not valid (required or bad value)
City :	Field not valid (required or bad value)
State :	Field not valid (required or bad value)
Zip :	Field not valid (required or bad value)
Date Of Birth :	Field not valid (required or bad value)
Hours Available :	Field not valid (required or bad value)
Place Of Employment :	Field not valid (required or bad value)
Job Description :	Field not valid (required or bad value)
Do You Have A Valid Oklahoma Drivers License? :	Yes No Field not valid (required or bad value)
Drivers License Number :	Field not valid (required or bad value)
Has your license ever been suspended or revoked? :	Yes No Field not valid (required or bad value)
If yes to the above, explain :	Field not valid (required or bad value)
Have You Been Convicted Of A Felony? :	Yes No Field not valid (required or bad value)
If yes to the above, explain :	Field not valid (required or bad value)
Do you have any desability or medical condition that might limit your training or firefighting performance? If yes, explain :
Field not valid (required or bad value)
Summarize any special skills and qualifications you have which pertain to your ability to serve as a firefighter. :
Field not valid (required or bad value)