NPFD Application for Membership

Name:

Address 1:

Address 2:

(Include PO Box Number if applicable)

City: , Wisconsin      Zip Code:

Birth Date:      Age:      Sex:  Male Female   Marital Status: Married Single

Soc. Sec. # --         Wis. Driver License # 

Please share your reasons for wanting to apply for membership below:

Area of interest:  Firefighter      Emergency Medial Technician      Both

Availability to respond:   Please indicate when you would normally be available to respond to calls.  If currently employed indicate your normal working hours.

Notes:

PROBATIONARY PERIOD OF MEMBERSHIP IS ONE YEAR: During the first year each member must fulfill all requirements according to the Fire Department By-Laws.

PHYSICAL EXAMINATION: After acceptance of this application the department requires each applicant to file a certificate of physical fitness from such physician as the Fire Chief may designate.

COMMITMENT: The North Prairie Fire Department requests a commitment of at least five years from members. The department may seek reimbursement of training costs from those who serve less than five years.

Under Wis. Act 27, the North Prairie Fire Department has the right to perform a Background and Criminal History check on all applicants prior to the acceptance of your membership.

This application will be submitted to the Fire Chief via the internet.  After submitting this application, an officer of the department will contact you to give you additional information, answer any questions you may have, and set up an interview.  During said interview, you will be required to sign a copy of this application to grant authority to the NPFD Fire Chief to perform a Background and Criminal History check.

Tell Us how to get in touch with you:

PLEASE NOTE: Make sure all text fields have entries so that your application can be processed correctly.