City of Seabrook Forms

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Seabrook Volunteer Fire Department Application for Membership

  1. PERSONAL INFORMATION

  2. TYPE OF MEMBERSHIP

  3. Which SVFD membership type do you have an interest in pursuing?*

  4. EMERGENCY CONTACT INFORMATION

  5. FIRE FIGHTING & EMERGENCY MEDICAL SERVICE EXPERIENCE

  6. EMPLOYMENT HISTORY

    List below all previous employers in the last 5 years starting with the most current. Use additional paper if necessary.

  7. REFERENCES

    Please list three character references

  8. CRIMINAL HISTORY

  9. Within the last three years have you been convicted of a Felony or Misdemeanor including moving traffic violations?*

  10. Do you have a Felony or Misdemeanor Case (including moving traffic violations) pending?*

  11. Have you ever forfeited a bond?*

  12. MEDICAL HISTORY

  13. Have you ever been diagnosed as, or been treated for having any of the following?

    Please check all that apply

  14. I, hereby make application for membership in the Seabrook Volunteer Fire Department.*

    By submitting this online form, I hereby affirm that all the foregoing statements on this application are true and correct. It is understood that a false statement on this application may be considered as sufficient cause for rejection or, if application is approved, dismisal from the Seabrook Volunteer Fire Department.

  15. Leave This Blank:

  16. This field is not part of the form submission.