Elkins Park Fire Company

7818 Montgomery Ave Elkins Park, PA 19027

Interested in becoming a member of the Elkins Park Fire Company? If so, please fill out the following application for approval which will be thoroughly reviewed by our Committee. Thank you for your interest in becoming a member.

Application For Membership

You are eligible to apply for membership with the Elkins Park Fire Company Active Department if you meet the following criteria:


1.	16 years of age to be voted into probationary membership
2.	A U.S. citizen
3.	Live or work within 3 miles from the Firehouse
4.	Can comply with the point system

My signature below signifies that I wish to apply for membership to Elkins Park Fire Company Active Department, that I agree to conform to the Bylaws and house rules, and that I give the Elkins Park Fire Company permission to examine any police records pertaining to me, both juvenile and adult.

Please fill in the information below:

Name:

DOB:

Age:

SSN:

Address:

Amount of time at this address:

Phone:

Previous Address:

	Job Title & work address (or schoolname):

	Operators license # & class desgination:

	Have you ever served in the Armed Forces?
	Yes No

	Please list any previous fire fighting experience:

Years of Service:

If yes, did you leave on good terms?

Yes No

Please, list contact person:

Have you ever been in Police Custody?

Yes No

If yes, please give reason:


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