Online Membership Application Personal InformationName *Street Address *Apartment, suite, etcCity *State *ZIP Code *Phone *Cell PhoneEmail Address *Date of Birth *Month *Day *Year *Age *Marital Status *SingleMarriedSeparatedDivorcedReligion *0 / 20Blood Type0 / 20Do you have an disabilities? *IdentificationPA Drivers License Number *License Expiration Date *Month *Day *Year *ResidencyAre you a local Resident? *YesNoHow many years? *0 / 2How many months? *0 / 2EmploymentEmployer Name *Street Address *CityStateZIP CodePhone *Email AddressHow long employed? *0 / 20What are your work hours?Firefighting ExperienceDo you have any previous firefighting experience? *YesNoIf yes, Where?Previous Chiefs NamePhoneEmail AddressMiscellaneousAre you sponsored or known by any of our members?Why do you want to join the Fire Company? *What type of Membership do you desire? *Class A - I understand I will have to attend Firefighter I training to be an Active MemberClass B - I will serve on committees and work fund raising functionsClass C - I wish to join the Fire Company AuxiliaryCertification *I understand I will be on probation for my first six (6) months of membership. I hereby give my consent to Levittown Fire Co. No. 1 to Investigate this application and all pertinent information pertaining to my character. I also understand that I will be required to submit and obtain a PA State Police Criminal Background check (https://epatch.state.pa.us/Home.jsp), a PA Child Abuse Clearance (https://www.compass.state.pa.us/cwis/public/home) and, if necessary, obtain an FBI background and fingerprint check. You will use the volunteer submission guidelines for each of the above links. Please submit the documents in the areas below with your application if you have them. Note: We cannot allow you to volunteer until all these documents have been received.Required documents:Copy of Drivers LicenseChoose FileNo file chosenDelete uploaded fileInsurance CardChoose FileNo file chosenDelete uploaded filePa State Police Criminal Background CheckChoose FileNo file chosenDelete uploaded fileVisit this link: https://epatch.state.pa.us/Home.jsp and use the New Volunteer Record optionPA Child Abuse CertificationChoose FileNo file chosenDelete uploaded fileFBI Background Check or Signed WaiverChoose FileNo file chosenDelete uploaded fileSubmit Your ApplicationPlease do not fill in this field.
