Murrysville Volunteer Fire Company #1

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2021 Incidents
Jan 26
Feb 14
Mar 41
Apr 31
May 49
Jun 40
Jul 33
Aug
Sept
Oct
Nov
Dec
Total 234

Past Incidents
2020 331
2019 459
2018 427
2017 434
2016 430
2015 511
2014 467
2013 424
2012 405
2011 440
2010 498
2009 460
2008 490

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Membership Application

MURRYSVILLE VOLUNTEER FIRE COMPANY #1

MEMBERSHIP APPLICATION

 

Required   Indicates Required Field
Personal Information
Last Name: Required
First Name: Required
Middle Name: Required
Date of Birth: Required
Street Address: Required
City: Required
State: Required
Zip Code: Required
Years at this address: Required
Phone #:
10 digit phone number only
Required
Email: Required
Driver's License #:
Include State if different than address
Social Security #:
Numbers Only
Housing Status: Required Own
Rent
Live with parents
Sex: Required Male
Female
Other
Height:
Feet, Inches
Required
Weight:
Pounds
Required
Marital Status: Required
Spouse / Partner Name:
Phone Number:
10 digit phone number only
Emergency Contact Name: Required
Emergency Contact Phone #: Required
Current Employer: Required
Employer Phone Number:
Direct Supervisor if applicable
Required
Background Information
Place of Birth:
(City/State) for completing background check
Required
Are you a Citizen of the USA?: Required YES
LEGAL ALIEN (Green Card)
NO
Previous firefighting experience: Required YES
NO
Description of Previous Firefighting Experience if any:
List Place and duration of service
Military Service: Required
Names of relatives or friends (current or past) in the Murrysville Volunteer Fire Company:
Reference 1 Name: Required
Reference 1 Phone #:
10 digit number only
Required
Reference 2 Name: Required
Reference 2 Phone#:
10 digit phone number only
Required
Reference 3 Name: Required
Reference 3 Phone #:
10 digit phone number only
Required
Have you been refused membership or removed from any firefighting or EMS service?: Required Yes
No
Are you under indictment for any crime?: Required Yes
No
Have you ever been convicted of a crime in any court? (Other than traffic court): Required Yes
No
Are you a fugitive from justice?: Required Yes
No
Do you have any driving citations?: Required Yes
No
Do you have any physical limitations or disabilities?: Required Yes
No
Do you have any medical conditions or allergies?: Required Yes
No
Have you ever received workman's compensation for an on-the-job injury?: Required Yes
No
Are you willing to submit for a physical evaluation within 30 days of acceptance?: Required Yes
No
Anything else you would like to add?:
Authorization
I agree that the above information is true and complete: Required Yes
No
Authorization 1 (Enter Name):
By entering my name here, as a digital signature, I certify that this application was completed by me and that all the entries and information are true and complete to the best of my knowledge. I hereby authorize Murrysville Volunteer Fire Company #1, it's agents, my employer(s), references and local and state police to furnish and information concerning my character, habits, health, history or employment. I hereby release all such persons from any and all liability or damages on account of having furnished this information, medical, criminal or otherwise.
Required
Authorization 2 (Enter Name):
By entering my name here, I hereby agree that I am requesting to join the Murrysville Volunteer Fire Company #1 on a one year probationary basis and that I may be terminated during this period as the sole discretion of the Murrysville Volunteer Fire Company #1. I hereby agree that the information supply in this application will be used for the purposes of investigation. I also fully understand that I may be denied membership if I do not live or work in the district of the Murrysville Volunteer Fire Company #1.
Required
Parent / Guardian Authorization (Enter Name):
If the applicant is under 18 years of age, a parent or authorized guardian must sign here. -- As the parent / legal guardian of the applicant, I authorize and attest to the same requested and stated in this application.
Required

Thank you for your interest in the Murrysville Volunteer Fire Company!

Someone will contact you soon to schedule an in-person interview; a copy of this application will be sent to the email entered above.

Click SUBMIT below when finished





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P.O. Box 93
3235 Sardis Road
Murrysville, PA 15668
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