Step 1 of 4 25% INFORMATION FOR APPLICANTSObjectives The objectives of Corolla Fire & Rescue Squad, Inc. are to provide fire protection, fire prevention, assistance, and care in natural or man-made disasters to the citizens of the Currituck Outer Banks, Currituck County, North Carolina. In order to effectively accomplish our objectives, Corolla Fire must maintain a constant nucleus of capable and adequately trained volunteers. To better ensure our ability to meet that goal, the Corolla Fire Board of Directors (Board) has approved the creation of a permanent Membership Committee.Membership Any person of good moral character who has reached his/her eighteenth (18th) birthday and who subscribes to the purposes and basic policies of the Corporation may become a member of the Corporation subject only to the compliance of the provisions of the By-laws, and rules and regulations as prescribed in the General Operating Guidelines (GOGs). Membership in the Corporation shall be available without regard to race, creed, or national origin. The Corporation will conduct a background check and/or drug test on any applicant and to use the results thereof in its determination of the suitability of the applicant for membership in the organization. Only members in good standing in the Corporation shall be eligible to participate in the activities of the Corporation, including meeting, drills or respond to calls, the use of facilities, or to serve in any of its elected or appointed positions, if permitted to do so in accordance with the By-laws. An applicant for membership must submit an application form, completed in full, to any member of the Membership Committee or a senior officer of the company. The Membership Committee shall review the application to ensure the applicant meets membership requirements and conduct an informal interview of the candidate. Upon completion of the review, the Committee shall present a summary of their findings and recommendations to the Fire Chief. If approved by the Fire Chief, applicants will become eligible for membership in Corolla Fire. A member whose application has been accepted by the Membership Committee and approved by the Chief will be placed on probation for three (3) months. All Probationary members must immediately work to meet the training and attendance requirements necessary to achieve Full member status. The Probationary member will be given an orientation to define his/hers obligations as a member of the Department. The Probationary member(s) must attend at least two regular business meetings and two training sessions within the first three (3) months. If a probationary member cannot meet the activity requirements in the initial period, probation may be extended for an additional three (3) months, only upon recommendation of the Membership Committee and approval of the Board of Directors. The Probationary candidate is expected and encouraged to demonstrate a willingness to participate in Corolla Fire activities and call response. However, while in probationary status, candidate will be restricted as follows: Probationary Candidates Response Restrictions Must obey all North Carolina traffic laws and Currituck County ordinances while responding to emergency calls. Cannot use any type of emergency warning lights or audible devices in their personal vehicle while on probation. The probationary candidate cannot ride on any apparatus responding to any type of emergency calls. The probationary candidate cannot be involved in any type of firefighting duties or be in the hot zone of an emergency scene. The hot zone is broadly defined as the area of fire/emergency scene that includes the areas forward and beyond the pump panels of the most distant fire apparatus. The probationary candidate should be observing and learning the ways, practices and guidelines of Corolla Fire and Rescue no matter what experience the candidate might have. The probationary candidate cannot perform any traffic duties until the candidate has the proper training in place from Corolla Fire and Rescue. The probationary candidate may assist with LZ’s (landing zones) as long as the candidate checks in with command and should have an officer or senior firefighter with the candidate. Probationary Candidates General Restrictions The probationary candidate cannot represent him/herself as a member of Corolla Fire and Rescue until the candidate is voted in as a full member. The probationary candidate cannot use the fire departments facilities for personal use such as working on their vehicle, using any type of tools, getting ice, and so on until voted in as a full member. The probationary candidate cannot use the departments’ or county’s computer or internet. The probationary candidate cannot be at any station by him/herself without a member of Corolla Fire and Rescue present. Currituck County personnel and Ocean Rescue personnel do not qualify as members of Corolla Fire and Rescue. The probationary candidate even with a member of Corolla Fire and Rescue present, the candidate must be out of the all stations by 21:00 so that the county medic crews can prepare for their rest and sleep time. (Fire calls will not be considered as a curfew violation). Probationary candidates are not permitted in “the hot zone”. The hot zone is broadly defined as the area of fire hazard or danger and includes areas forward and beyond the pump panels of the most distant fire apparatus. Probationary candidates shall not be permitted to drive or operate or ride in any fire apparatus, nor shall they drive or operate support vehicles. Probationary candidates, with proper training, may assist in support activities to include traffic control, Rehab support, staging tools and equipment, post event clean-up, re-packing fire hose, or other activities as may be directed by scene command. If the active scene is an LZ (Landing Zone), Probationary candidates shall check-in with LZ Command for assignments. If at any time during the probationary period, the applicant proves unworthy of becoming a regular member, either by falsification of application information or by actions determined to be detrimental to Corolla Fire, the Membership Committee or the Fire Chief will recommend to the Board of Directors that the candidacy of the applicant be terminated. The Membership Committee will then notify the candidate of the decision. At the end of the probationary period the successful Probationary member(s) will be presented to the membership at a scheduled business meeting. A ballot will be taken to approve the candidate as a regular member of the Fire Department. The voting procedure will require a majority approval by the regular membership present at the meeting. Once accepted, the new member shall be required to sign the Oath of Commitment to Corolla Fire & Rescue.The Oath of Commitment to Corolla Fire and Rescue I (name) promise to obey the rules and regulations of Corolla Fire and Rescue to the best of my ability and to follow the requests or directions given to me by the Officers of Corolla Fire and Rescue in the execution of my duties as a volunteer firefighter and to conduct myself at all times in a manner befitting my fellow firefighters and Corolla Fire and Rescue. CRITERIA AGREEMENTAs a full member of the Corolla Fire & Rescue Squad organization, I understand my membership requires meeting the following criteria: Achieve at the minimum thirty-six (36) hours of drills, Firefighter 1 and 2 skills training, and training meetings a year. Regularly attend meetings, both business and training. Members are encouraged to attend at least 50% of meetings yearly. Respond to and participate in fire calls and other emergencies as appropriate. Participate regularly in apparatus, equipment, station specific training or routine maintenance and perform other duties as assigned/requested by the Chief. Minimum of one year of membership in the Department. Will be issued all appropriate Turnout Gear, as a Firefighter, or approved "REHAB" gear as a member of the REHAB group. All Full Members meeting the criteria as of the end of the calendar year will be eligible to participate in the North Carolina Firemen’s and Rescue Squad Worker’s Pension Fund (Pension). Any Full Member failing to attain the required thirty-six (36) hours of drills, FF I and II skills training and training meetings by the end of the calendar year shall revert back to Associate Member status. Members may also be placed on a Probationary Status until re-attaining the requirements for Full Member.Background Check Corolla Fire & Rescue will conduct a background and driver’s license check on each new applicant. I understand and agree to the foregoing stipulationsApplicant Signature*Date* Month Day Year APPLICATION FOR MEMBERSHIPName* First Middle Last Social Security Number*Date of Birth* Month Day Year Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Cell Phone Number*Home Phone Number*Work Phone Number*Do you have any known disabilities or medical issues that may limit or preclude participation as a firefighter?* Yes No If yes, a doctor’s note / letter, explaining your circumstances, will need to be kept on file. Please describe below:I am willing to participate in the following (please check all that apply):* Building Cleanup Business Meetings Clean Fire Trucks Fund Raising Activities Respond to Fire Calls Serve on Committees Serve with Rehab Group Training Functions Yard / Property Upkeep Other Tasks as May Apply I, the undersigned applicant, have reviewed and understand the “Information for Applicants” statement which outlines the membership criteria of the Corolla Fire & Rescue Squad, Inc.Applicant Signature*Date* Month Day Year PERSONNEL FILEName* First Middle Last Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work Phone*Cell Phone*Email* Social Security Number*Date of Birth* Month Day Year Driver's License Number*State* AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Class*Expires* Month Day Year Employer*Employer Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Information In Case of EmergencyName* First Last Relationship*Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work Phone*CAPTCHAEmailThis field is for validation purposes and should be left unchanged.