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APPLICATION

Thank you for considering membership to the Town Line Volunteer Fire Department. Please complete the application below. After the application is completed, you will be contacted in a few days to discuss your qualifications further and explore next steps.

Town Line Volunteer Fire Department

Membership Application

Are you 18 years or older?
Is additional information about a change in your name or use of an assumed name necessary to enable a check of your eligibility for membership?
Do you have a valid New York State License
Have you ever been convicted or pled guilty to a felony, misdemeanor, insurance fraud, or reduction to one of these offenses? (If yes, please give details in section entitled "Additional Information")

EMPLOYMENT

Are you currently employed?
If yes, can we contact your employer for a reference?

AVAILABILITY AND INTERESTS

Please indicate your availability to participate in department activities (alarm response, drills, meetings, etc.)
Being a member has many facets. This section is to give the department a general idea of your interest. As training progresses, we understands these interests may change. Please check all that apply:
How did you hear about us?

EXPERIENCE

Have you ever been a member of a fire department or EMS agency? (You will need a letter from your previous department stating you are no longer a member when you are interviewed by our Membership Committee.)

If yes, please provide the following information.

ADDITIONAL INFORMATION

APPLICANT STATEMENTS

I hereby make application to become a member of the Town Line Volunteer Fire Department, Inc., I promise cheerful compliance to all laws, rules, and regulations of said department and pledge myself to respond to alarms and attend training and department meetings. I understand that I will undergo a probationary period of at least one (1) year after becoming a member and thereafter live up to all obligations of an active firefighter. I also pledge strict and prompt obedience to the orders of the chief and his duly constituted assistants when at fire or drills. I will also complete the New York State Basic Exterior Firefighter Operations Course or the New York State Interior Firefighting Operations Course (prior equivalent courses must be approved by the Chief) and the Town Line Volunteer Fire Department Entry Level 1 Training Course during my first eighteen (18) months of membership.


In addition to the Criminal Background Check sent to the Lancaster Police Department, the Town Line Volunteer Fire Department will also submit an Arson Background Check and Registered Sex Offender Check to the Erie County Sheriff as required by New York State Law. Your signature below serves as authorization for us to conduct this check.


IN WITNESS WHEREOF, THIS APPLICATION HAS BEEN SUBSCRIBED BY THE UNDERSIGNED APPLICANT WHO AFFIRMS THAT THE STATEMENTS MADE HEREIN ARE TRUE UNDER THE PENALTIES OF PERJURY.

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Section 94 of the Public Officers Law (Personal Privacy Protection Law) requires that you be notified of the following facts when information which will be maintained in a record system is collected from you. The authority to request and confirm personal information from you is found in Article 6 of the Executive Law.


The information obtained will (1) be used to determine your qualifications for membership of the department, (2) be released to the fire chief and potential supervisors; and (3) be maintained in your personnel file (if you become a member of the department) or in your resume file for six months if you do not become a member.


Failure to provide the information requested will result in your application not being considered for membership. The information in this application will be maintained by the Department Records Officer, Town Line Volunteer Fire Department, Inc. 6507 Broadway Street, Lancaster, New York 14086.

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