Application For Membership - Bellmawr Fire Department (Page 5 of 7) in pdf

Application For Membership - Bellmawr Fire Department Page 5

Additional Information:

TRAINING:

Please list any specialized training in the fire or life safety field. Submit copies of Certifications.

SPECIAL SKILLS:

List proficiency with any heavy machinery, industrial equpiment, or specialized training you may have.

List any COMPUTER skills you may possess, i.e., hardware, software applications, progamming skills, etc.

BACKGROUND:

Have you been fired from a job or organization or asked to resign in the last 10 years? No Yes

If yes please explain:

Have you ever been convicted of any law violation in the last TEN years, excluding minor traffic offenses, which have not

been annulied, expunged or sealed by the court? Include any please of “guilty” or “no contest”. (A conviction will not

necessarily disqualify an applicant for membership.)  No  Yes – If yes, Please explain in full:

Do you have a valid driver’s license? No Yes – Licnese :__________________________State:_____________Class______

A PHOTOCOPY OF YOUR DRIVER’S LICENSE MUST BE ATTACHED TO THIS APPLICATION.

Have you ever had your license suspended or revoked within the last THREE years? No Yes – Give details:

Application For Membership - Bellmawr Fire Department Page 5