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| What group are you interested in participating? | |
| Are you interested in forming your own Ruth Community Auxiliary Group? |
Basic Information
| NAME | |
| ADDRESS | |
| CITY | |
| STATE | |
| ZIP | |
| PHONE | |
| DOB | |
| SOC |
Personal Information
| What are your work hours? | |
| Do you know anyone in the Ruth VFD? | |
| If so, who? | |
| Education level? | |
| Been convicted of a felony? | |
| If so, for what and when? | |
| Do you have Fire Fighting experience? | |
| If so, with who? | |
| Please list all of your current certifications and licenses in the box. |
Provide Three References
|
Reference #1 |
Reference #2 | Reference #3 | |||
| Name: | Name: | Name: | |||
| Phone: | Phone: | Phone: | |||
| Relationship: | Relationship: | Relationship: | |||
Comments:
I give consent to the administrators of the Ruth VFD to submit this information to any agency they see appropriate for background checks.
I have reviewed my answers to all of the questions below and certify that all the information I have provided is accurate to the best of my knowledge.