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Application Form

Please list any memberships in organizations, hobbies, outside interest, etc you belong to.
Organization/Hobbies/Outside Interest
Organization/Hobbies/Outside Interest
Organization/Hobbies/Outside Interest
Organization/Hobbies/Outside Interest
Organization/Hobbies/Outside Interest
Organization/Hobbies/Outside Interest
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I DO HEREBY DECLARE THAT SHOULD I BE SUCCESSFUL IN MY APPLICATION FOR MEMBERSHIP IN THE FUTURE FIREFIGHTER PROGRAM, I WILL OBEY AND ABIDE BY THE RULES AND REGULATIONS, STANDING ORDERS, JOB DUTIES, ETC OF THE FIRE DEPARTMENT AS DESCRIBED TO ME IN THIS PROGRAM. FAILURE TO COMPLY WITH THESE RULES, I UNDERSTAND I WILL BE SUBJECT TO DISCIPLINARY ACTION OR EJECTION FROM PROGRAM. I ALSO UNDERSTAND THAT THIS IS A FULL FIREFIGHTING COURSE AND ALTHOUGH I WILL BE PROTECTED, THERE IS STILL SOME LEVEL OF RISK INVOLVED.
Applicant Name*
Applicant's Parent/Legal Guardian Signature *
Electronic Signature Agreement*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature*
Parent/Legal Guardian of Applicant Signature

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