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RAMSEY FIRE DEPARTMENT <br />APPLICATION FOR MEMBERSHIP <br /> <br />Name .. 4 r=,,x. <br /> <br />Firm <br /> <br />Midd}e <br /> <br />Address ).~,7OO _C-,4~N~T 57' ~V,~, <br /> $~rcct <br /> <br />City' <br /> <br />Zip <br /> <br />Phone No. 7~z-~- ~:~ q~ <br /> <br />Are you over age 187 Yes w." No__ <br /> <br />Are you under 65? 5'es t,--"' No__ <br /> <br />EM PLOYMENW: <br /> <br /> Nm-ne <br /> <br />Working Hours. <br /> <br />Could you leave work to respond to a fire,'? <br /> <br />Yes No t,-'" <br /> <br />Could you obtain written authorization to icav¢, work7 <br /> <br />Yes ~ No <br /> <br />~DUCATION: <br /> <br /> Namg, of $choo! <br />High School ...'.'SAZ. OT ~v'~,r4.',/'~ (~Z.5,'~A~J", ro~] <br /> <br />College or <br />Trade School <br /> <br /># of 'Year,~ A trended <br /> <br />No applicant testing positive for nicotine shall be accepted for membership. <br /> <br /> <br />