bethesda chevy chase rescue squad

Membership Application

BETHESDA-CHEVY CHASE RESCUE SQUAD MEMBERSHIP APPLICATION
5020 Battery Lane, Bethesda, MD 20814
301-652-0077
Incomplete applications will not be considered. All entries must be filled in.

Personal Information

Membership in the Montgomery County Fire and Rescue Service requires the completion of criminal history and reference/background checks. Candidates for membership will need to provide personally identifiable information including full social security and driver's license numbers at their initial interview. Candidates will also be required to submit fingerprints at a later stage in the process.

Yes No

Emergency Contact Information

Education

Yes No

Present or Most Recent Position

Former Position

Military Service

General Information

(Affirmative responses to the following questions will not automatically exclude you from being considered for membership. However, complete and accurate information must be provided.)


Yes No

Yes No

Yes No

Yes No

Yes No

CHARACTER REFERENCES

(List two references who are not related to you.)

SHORT ESSAY

Please explain why you would like to become a member of the Rescue Squad.

SIGNATURE REQUIRED

Please be sure you have signed and dated the form below and that you have answered every question clearly and completely. During you probationary class you will be required to perform a patient lifting ability test. This test has been designed to assure that applicants are able to participate in the necessary, physically demanding activities of the fire and rescue services. The testing procedures will be explained to you during your probationary class. Each applicant has two chances to pass the test. For reasons of safety, continuation of the application process is contingent on the passage of the test.

By signing below you are certifying that you are applying for a position with the Bethesda-Chevy Chase Rescue Squad and that you herby authorize the release of any and all information to the Bethesda-Chevy Chase Rescue Squad that we may request, from any of your records or files. Such information will include, but will not be limited to: military records, police records, credit records, banking records, arrest records, court records, traffic records, confidential records, educational records, employment records, etc. You also release all persons from any and all liability which could result from furnishing said information to the Bethesda-Chevy Chase Rescue Squad, Inc. or any of its agents. Further, you authorize the Bethesda-Chevy Chase Rescue Squad, Inc. to copy or otherwise reproduce this original document, and let such copied or otherwise reproduced copy act as the original instrument. The original document is to be retained on file with the Bethesda-Chevy Chase Rescue Squad and this authorization to release information shall not expire.

I, the undersigned, certify that I have read and fully understand this form in its entirety and that the information herein provided is true and complete to the best of my knowledge. I understand that, should any statement I have made prove to be false, misleading, or erroneous, it may result in the rejection of my application or in my discharge from the Rescue Squad. I further agree that I will pay the $20.00 initiation fee after my probation. I also agree to uphold the rules, regulations, and by-laws of the Bethesda-Chevy Chase Rescue Squad.

HELP US FIND MORE APPLICANTS LIKE YOU!

How did you learn about the Rescue Squad?

Internet
Word of mouth
From a Rescue Squad member
Sign in front of Rescue Squad
Newspaper ad
Other
Junior Membership Application

BETHESDA-CHEVY CHASE RESCUE SQUAD JUNIOR MEMBERSHIP APPLICATION
5020 Battery Lane, Bethesda, MD 20814
301-652-0077
Important: You must be at least 16 years old to submit an application to the Rescue Squad This application requires a parent signature. Applications submitted without such signature will not be considered for membership

Personal Information

Membership in the Montgomery County Fire and Rescue Service requires the completion of criminal history and reference/background checks. Candidates for membership will need to provide personally identifiable information including full social security and driver's license numbers at their initial interview. Candidates will also be required to submit fingerprints at a later stage in the process.

Yes No

Emergency Contact Information

Education

Present or Most Recent Position

Former Position

SHORT ESSAY

In 100 words or less please explain why you would like to become a member of the Rescue Squad. Please list below any additional information you consider pertinent to your application for membership (including school honors, organization memberships, unique skills, etc.)

General Information

(Affirmative responses to the following questions will not automatically exclude you from being considered for membership. However, complete and accurate information must be provided.)


Yes No

Yes No

Yes No

Yes No

Yes No

CHARACTER REFERENCES

(List two references who are not related to you.)

SIGNATURE REQUIRED

Please be sure you have signed and dated the form below and that you have answered every question clearly and completely. During you probationary class you will be required to perform a patient lifting ability test. This test has been designed to assure that applicants are able to participate in the necessary, physically demanding activities of the fire and rescue services. The testing procedures will be explained to you during your probationary class. Each applicant has two chances to pass the test. For reasons of safety, continuation of the application process is contingent on the passage of the test.

By signing below you are certifying that you are applying for a position with the Bethesda-Chevy Chase Rescue Squad and that you herby authorize the release of any and all information to the Bethesda-Chevy Chase Rescue Squad that we may request, from any of your records or files. Such information will include, but will not be limited to: military records, police records, credit records, banking records, arrest records, court records, traffic records, confidential records, educational records, employment records, etc. You also release all persons from any and all liability which could result from furnishing said information to the Bethesda-Chevy Chase Rescue Squad, Inc. or any of its agents. Further, you authorize the Bethesda-Chevy Chase Rescue Squad, Inc. to copy or otherwise reproduce this original document, and let such copied or otherwise reproduced copy act as the original instrument. The original document is to be retained on file with the Bethesda-Chevy Chase Rescue Squad and this authorization to release information shall not expire.

I, the undersigned, certify that I have read and fully understand this form in its entirety and that the information herein provided is true and complete to the best of my knowledge. I understand that, should any statement I have made prove to be false, misleading, or erroneous, it may result in the rejection of my application or in my discharge from the Rescue Squad. I further agree that I will pay the $20.00 initiation fee after my probation. I also agree to uphold the rules, regulations, and by-laws of the Bethesda-Chevy Chase Rescue Squad.


HELP US FIND MORE APPLICANTS LIKE YOU!

How did you learn about the Rescue Squad?

Internet
Word of mouth
From a Rescue Squad member
Sign in front of Rescue Squad
Newspaper ad
Other

Parent's Personal Data Sheet

For BCC Rescue Squad Junior Probationary Member

Junior Member:

Administrative Application

BETHESDA-CHEVY CHASE RESCUE SQUAD MEMBERSHIP APPLICATION
5020 Battery Lane, Bethesda, MD 20814
301-652-0077
Incomplete applications will not be considered. All entries must be filled in.

Personal Information

Membership in the Montgomery County Fire and Rescue Service requires the completion of criminal history and reference/background checks. Candidates for membership will need to provide personally identifiable information including full social security and driver's license numbers at their initial interview. Candidates will also be required to submit fingerprints at a later stage in the process.

Yes No

Emergency Contact Information

Education

Yes No

Present or Most Recent Position

Former Position

Military Service

General Information

(Affirmative responses to the following questions will not automatically exclude you from being considered for membership. However, complete and accurate information must be provided.)


Yes No

Yes No

Yes No

Yes No

Yes No

CHARACTER REFERENCES

(List two references who are not related to you.)

SHORT ESSAY

Please explain why you would like to become a member of the Rescue Squad.

SIGNATURE REQUIRED

Please be sure you have signed and dated the form below and that you have answered every question clearly and completely. During you probationary class you will be required to perform a patient lifting ability test. This test has been designed to assure that applicants are able to participate in the necessary, physically demanding activities of the fire and rescue services. The testing procedures will be explained to you during your probationary class. Each applicant has two chances to pass the test. For reasons of safety, continuation of the application process is contingent on the passage of the test.

By signing below you are certifying that you are applying for a position with the Bethesda-Chevy Chase Rescue Squad and that you herby authorize the release of any and all information to the Bethesda-Chevy Chase Rescue Squad that we may request, from any of your records or files. Such information will include, but will not be limited to: military records, police records, credit records, banking records, arrest records, court records, traffic records, confidential records, educational records, employment records, etc. You also release all persons from any and all liability which could result from furnishing said information to the Bethesda-Chevy Chase Rescue Squad, Inc. or any of its agents. Further, you authorize the Bethesda-Chevy Chase Rescue Squad, Inc. to copy or otherwise reproduce this original document, and let such copied or otherwise reproduced copy act as the original instrument. The original document is to be retained on file with the Bethesda-Chevy Chase Rescue Squad and this authorization to release information shall not expire.

I, the undersigned, certify that I have read and fully understand this form in its entirety and that the information herein provided is true and complete to the best of my knowledge. I understand that, should any statement I have made prove to be false, misleading, or erroneous, it may result in the rejection of my application or in my discharge from the Rescue Squad. I further agree that I will pay the $20.00 initiation fee after my probation. I also agree to uphold the rules, regulations, and by-laws of the Bethesda-Chevy Chase Rescue Squad.

HELP US FIND MORE APPLICANTS LIKE YOU!

How did you learn about the Rescue Squad?

Internet
Word of mouth
From a Rescue Squad member
Sign in front of Rescue Squad
Newspaper ad
Other