Howlett Hill Fire Department

Do you reside in the Howlett Hill Fire District?

YesNo

Your Name: (required)

Street:

City:

State:

Apt:#

Zip:

Home Phone (include area code) (required):

If this a mobile phone?

YesNo

Mobile Phone Provider

What email address do you use:

Your Emergency contact name:

Your Emergency contact phone number (include area code):

Date of Birth

Drivers License #:

Drivers License Which State:

Employer:

Your Occupation:

Employer Address:

Work Phone#:

Normal Work Hours:

Previous Fire Departments Membership(s):

Previous Fire, Rescue, Medical Experience:

Have you any physical issues that would prevent you from performing firefighter duties?

YesNo

If Yes, please explain in detail.

Recommended By:

I certify that all the statements above are true and correct to the best of my knowledge.
I recognize that any false statements made may subject me to immediate discharge. I hereby give the Howlett Hill Fire Department, Inc. the right to verify any statements made in the above application.
I understand a mandatory Arson and Sexual Violence background Check, required by New York State law, will be requested and performed by the Onondaga County Sheriff Office.
By applying for ACTIVE MEMBERSHIP to the Howlett Hill Fire Department, I understand that a minimum number of training hours and business meetings must be attended to remain in good standings.
Also, I understand that I am expected to respond to ALL alarms for which I am available.

Signature:

Date:

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