Join Our Team!

Use the form below to apply for membership to the Bay District Volunteer Fire Department. After completing this form, a representative of the membership committee will contact you. In the meantime, feel free to come down and visit the stations.

The Bay District Volunteer Fire Department has Three (3) Membership types:

Associate – Open to all persons 16 years and older. Associate Membership provides support to the Bay District Volunteer Fire Department by assisting with Fire Prevention, Fund Raising and Fire Ground Rehabilitation.

Junior Membership – open to all persons 16 – 17 years old. Junior Members participate in all firefighting activities (i.e. – responds to emergency incidents, participates in training, assist with fund raising and performs fire prevention activities.

Senior Membership – Senior Membership is open to all persons 18 and older. Senior Members participate in all firefighting activities (i.e. – responds to emergency incidents, participates in training, assist with fund raising and performs fire prevention activities.

*All prospective members MUST print the BDVFD Health Certificate and have it filled out by your physician and returned to Bay District Volunteer Fire Department prior to being accepted into probationary membership”

*Prospective members will be required to pay a non-refundable background check fee of $15.00 at the first membership meeting prior to acceptance of application.

PERSONAL
Membership Type	Select Membership Associate Junior Senior
Last Name		Date
First Name		E-mail Address
MI
Street Address
City, State, Zip
How long have you lived at this address?
Home Phone		Business Phone
Sex (M/F)
Where are you currently employed?
If you were in the Armed Forces, when were you discharged? Month/Year
Are you over 18 years of age?
Date of Birth
Have you ever been convicted of a traffic violation, misdemeanor, or a felony
If Yes, indicate the date and nature of the charge, police agency, court and disposition.
EXPERIENCE
Have you ever filed an application Bay District Volunteer Fire Department?
If so, when?
Have you ever been denied membership to a fire and/or rescue squad?
If so, please give details.
Have you ever been discharged for misconduct or unsatisfactory service or asked to resign from a fire and/or rescue department?
If so, please give details.
List any fire fighting and/or emergency medical certifications that are current. Please provide copies of certifications
Certifications		State
EDUCATION
High School attended		Location (City/State)
Did you graduate or receive a GED?		Date graduated, or received GED
College or University	Location (City/State)	Dates attended	Major or Degree awarded
MEDICAL HISTORY
Have you ever...	had an operation?		Select Answer No Yes
	been seriously injured?		Select Answer No Yes
	been refused employment for reasons of health?		Select Answer No Yes
	been forced to resign from a job or volunteer position for health reasons?		Select Answer No Yes
	fractured any bones or dislocated any joints?		Select Answer No Yes
	been refused life insurance?		Select Answer No Yes
	been diagnosed with an illness caused by your job or volunteer position?		Select Answer No Yes
	injured your back?		Select Answer No Yes
	suffered from lung problems?		Select Answer No Yes
	suffered from heart problems?		Select Answer No Yes
	suffered from swelling of the legs or ankles?		Select Answer No Yes
	suffered from fainting spells or dizziness?		Select Answer No Yes
	suffered from frequent headaches?		Select Answer No Yes
	been hospitalized or on medication for mental illness?		Select Answer No Yes
Do/are you...	currently wearing glasses?		Select Answer No Yes
	using a hearing aid?		Select Answer No Yes
	on any medications?		Select Answer No Yes
If you answered yes to any of the above, please provide more information.
REFERENCES
Please list 3 references, not related to you by blood, adoption, or marriage, which you have known for at least one year. References should not be members of Bay District Volunteer Fire Department.
NAME	ADDRESS	WORK PHONE #	HOME PHONE #
Please provide any previous fire departments or rescue squads that you have been a member of:
DEPARTMENT	ADDRESS	CHIEF OFFICER	PHONE NUMBER
The following information must be provided by Junior Member (Age 16 & 17) Applicants :
Report Card (If still in High School)
Drivers License #		State Issued
EMERGENCY CONTACT
Name
Relationship
Address
Phone Number
ACKNOWLEDGEMENT
By signing below, I signify that I have applied for the membership to the Bay District Volunteer Fire Department; that I have answered all questions truthfully and to the best of my knowledge; and that I fully understand that any intentional false statement may be grounds for dismissal from the department. Furthermore, I hereby grant to Bay District Volunteer Fire Department permission to contact my employer, references, and any other persons or agencies who may have knowledge of me, my skills and my experience as may be deemed necessary.  If you have any questions please contact membership@bdvfd.org.
Please type your signature here:
Who may we thank for referring you?
For security protection, please provide the SUM for the mathematical equation:

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