2025 Application Rochester Volunteer Fire Company Membership Application Leave this field empty Contact Information First Name * Last Name * Preferred Name (optional) Email Address * Primary Phone * Secondary Phone (optional) Address Address Line 1 Address Line 2 City State ZIP / Postal Code Membership Type and Interests Membership Types: Full Member: Responds to calls, participates in night crews, and attends regular training. Associate: Supports the department with a minimum number of hours each month, which may include calls, events, or station staffing. Explorer: Youth member through the BSA Explorers program with training and ride-alongs. Additional BSA Explorer application paperwork will also be required. Part Time: Hired for scheduled daytime shifts (typically 0800–1600). Membership Type * Select a type Full Member Associate Explorer Part Time Areas of Interest (check all that apply) Fire EMS Support Availability Weekday availability (check all that apply) Weekdays 0800–1600 Weekday evenings Weekday overnights Weekend availability (check all that apply) Weekend days Weekend evenings Weekend overnights Experience and Background Do you have prior fire service experience? Yes No Do you have prior EMS experience? Yes No Highest EMS license level (current or most recent) Select EMS license level EMR (Emergency Medical Responder) EMT (Emergency Medical Technician) AEMT (Advanced EMT) Paramedic Critical Care Paramedic If you answered Yes to prior EMS experience, please select your highest license level. Age Range Prefer not to say Under 18 18–20 21–24 25–34 35–44 45–54 55 or older Tell Us About Yourself Anything else you would like us to know? Optional Attachments Upload CV (PDF, DOC, DOCX) Upload Resume (PDF, DOC, DOCX) Submit Application
