MEMBERSHIP APPLICATION

If you are interested in joining the Belmont Fire Company, please complete the application to your right and be sure to answer all the questions within the application.

Your application will be sent to the right department for further review.  You will hear back from us once we have had a chance to review your information.

Membership Application

PERSONAL INFORMATION

All fields are required
Do you have a Drivers License *
Sex *
Do you wear *
Are you a US Citizen? *
Do you have a legal right to be in the US? *
Have you ever been a member of the United States Armed Forces? *
Did you receive an honorable discharge? *
Have you received disability or compensation benefits for any injury? *
Do you have restrictions that may affect your ability to participate in fire department activities? *

CONTACT INFORMATION

Please check all that apply *

EMERGENCY CONTACT INFORMATION

Are you a prior or current Fire / EMS Member of any other department *

PRIOR or CURRENT FIRE/EMS EXPERIENCE

Would they provide a letter of recommendation?
Are you a member in good standing?
Disclaimers - ALL MUST BE CHECKED IN ORDER TO CONTINUE *
Checkboxes