Apply To Be a Member – Metal Township Fire Company

Current Membership Application

Date*
MM slash DD slash YYYY

Social Security #

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*
Email*

Date of Birth*
MM slash DD slash YYYY

Age*

Must be 14 yrs or older
What type of membership are you interested in?*
Regular
Social
Junior
Regular - May hold elective office, has the right to vote at meetings, must attend six or more meetings in a calendar year to vote, may drive apparatus as designated by the Fire Chief, may be elected to Line Officer positions. It shall be the duty of each regular member to attend company activities when possible.
Social - Will not hold an elective office, may attend meetings but will not have the right to vote, may not drive the company apparatus unless approved by the Fire Chief. Junior Members cannot be Social Members
Junior - All persons between the ages of fourteen (14) and eighteen (18) will be considered Junior Members except when that member graduates from high school and is seventeen (17) years of age at which time they will be considered a regular member
What service of Fire Co. are you interested in?*
Firefighting
Ambulance
Fire Police
Fundraising
Please attach a list and copies of any certificates from courses that you have taken. We cannot give you credit without copies of your certificates.

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 8 MB.

Employer*

Occupation*

Work Phone*
Ext.

Military Service:
Yes
No
Discharge:
Honorable
Dishonorable
Medical
Have you ever been convicted of a crime?*
Yes
No
If Yes, please attach an explanation of type of conviction and any details that we should know about

Drop files here or

Accepted file types: doc, jpg, gif, pdf, txt, Max. file size: 8 MB.

ALL NEW APPLICANTS ARE SUBJECT TO A PENNSYLVANIA STATE POLICE CRIMINAL RECORD CHECK
REFERENCES: Please list two (2) personal references who are not family members. At least one (1) reference must be a fire company member.
Name*
First Last
Phone*
Name*
First Last
Phone*
I certify all statements made herein are correct. I agree to abide by the constitution and By-Laws and all rules and regulations as set forth by the Metal Township Fire and Ambulance Company and any of its officers.
Signature*

Date*
MM slash DD slash YYYY

For all applicants under the age of 18 years, a parent/guardian must also read the statement below and sign. I certify that I have read and understand this application and its contents and give my permission for my son/daughter to become a member of the Metal Township Fire and Ambulance Co., Inc. I also understand that my son/daughter must abide by the constitution and By-Laws and all rules and regulations as set forth by the said company and its officers pending the signature of this application
Signature*

Date*
MM slash DD slash YYYY

Phone*
Fee
Price: $5.00
Per year (Non-Refundable)
Membership fee is waived for Junior Members, all active military personnel and if application is approved during the months of October, November and December. Otherwise, fee is due prior to application being submitted to members.
*NOTE*
This application must be filled out in its entirety. It will be submitted to the members at the next general meeting for submission of criminal record check. If favorable criminal record check is received, this application will be submitted at the next general meeting for members to vote by secret ballot. If not more than three (3) negative votes have been cast, the applicant shall be declared a probationary member. After serving a six (6) month probationary period this application will be presented to members at a general meeting for final approval of membership. Upon final approval, the member’s date of record will be retroactive the date of probationary membership approval

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