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RAMSEY FIRE DEPARTMENT <br />APPLICATION FOR MEMBERSHIP <br /> <br />Name <br /> <br />Address _W'";... oo <br /> <br />Firs~ <br /> <br /> CiD' Sta~e <br /> <br />Phone No. g~z) ~ z.z~-,-/~q I <br /> <br />Middie <br /> <br />Are you over age 187 Yes X' No <br /> <br />Zip <br /> <br />Are you under 657 Yes P<' . No <br /> <br />EMPL,OYME~.Z: <br />Present Empi% er <br /> <br />Position <br /> <br />Working Hours .3 '. po,on . to I t · coo~o~ <br />Could you leave work to respond to a gLre? Yes __ <br />Couid you obtain written authorization to leave work? Yes 2< <br /> <br />No <br /> <br />EDUCATION: <br /> <br />Name of School <br /> <br /># of Years Anended <br /> <br />High School <br /> <br />College or <br /> <br />Other Special <br />Training <br /> / <br /> <br />No applicant testing positive for nicotine shall be accepted for membership. <br /> <br /> <br />