Required fields are marked with asterisks (*)

Fire Services Application for Membership

Saddle Hills County

Thank you for your interest in volunteering to protect our communities.

Date (yyyy-mm-dd):

Which Fire Department are you applying to join

Blueberry

Bonanza

Happy Valley

Savanna

Woking

Don’t Know

Name

Date of Birth

Mailing address

City/Town

Postal Code

Phone (work/home)

Cell Phone Number

Home Address

Occupation

Current Employer

Time with Current Employer

Previous Employers

Previous fire service experience

Training courses (fire or other)

Reference 1:

Ref. 1 Phone:

Reference 2:

Ref. 2 Phone:

Signature

Clear

By checking this box, which functions as your legal signature, you confirm that the information provided is as complete and accurate as possible

I understand that checking this box constitutes a legal signature

Notice of Collection

The personal information on this form is being collected for the purpose of determining eligibility to serve with one of Saddle Hills County's Volunteer Fire Departments and will be shared with Council and Administration. The information is collected under the authority of Section 146 of the Municipal Government Act and Section 4 of the Protection of Privacy Act. For questions about the collection of personal information, contact admin@saddlehills.ab.ca or call (780) 864-3760.

Please send me a pdf copy of this form

Yes

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