Camelot Volunteer Fire and Rescue

Online Application

This is a pre-application only. You will need to fill out further paperwork at your first meeting.

* Denotes required field.

* Name:
* Date of Birth: (ex. 01/01/1970)
Social Security Number: (ex. 111-22-3333)
* Address:
* City:
* State:
* Zip:
Email Address:
* Home Phone: (ex. 210-555-1212)
Work Phone: (ex. 210-555-1212)
Place of Employment:
* Person to Notify in Case of Emergency:
* Emergency Contact Phone: (ex. 210-555-1212)
* Hospital Preference:
* Do you have any physical or medical conditions which may prevent you from performing any firefighting/rescue duties?	YES NO
If yes, explain:
* Do you have firefighting experience?	YES NO
If yes, where?
* List all certifications and/or training: If no training or certifications, list "none"
* Driver's License Number:
* State:
* Class: