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Fire Services Application for Membership

Saddle Hills County

Thank you for your interest in volunteering to protect our communities.

Date (yyyy-mm-dd):

Which Fire Department are you applying to join

Blueberry

Bonanza

Happy Valley

Savanna

Woking

Don’t Know

Name

Date of Birth

Mailing address

City/Town

Postal Code

Phone (work/home)

Cell Phone Number

Home Address

Occupation

Current Employer

Time with Current Employer

Previous Employers

Previous fire service experience

Training courses (fire or other)

Reference 1:

Ref. 1 Phone:

Reference 2:

Ref. 2 Phone:

Signature

Clear

By checking this box, which functions as your legal signature, you confirm that the information provided is as complete and accurate as possible

I understand that checking this box constitutes a legal signature

Notice of Collection

Protection of Privacy - The personal information requested on this form is collected under the authority of Section 33 (c) of the Alberta Freedom of Information and Protection of Privacy Act and will be protected under Part 2 of that Act. It will be used for the purpose of assessing elgibility to join the County's Fire Services. Direct any questions about this collection to: FOIP Coordinator, Saddle Hills County, RR 1, Spirit River, Alberta, Canada, T0H 3G0, 1-888-864-3760.

Please send me a pdf copy of this form

Yes