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Pr. RS ~ <br /> <br />Do you hold <br /> <br />If ),es, whm driV, ers' license class? <br /> <br />Have vou ever re, ken an>, first aid training classes? Yes .~ <br /> <br />No <br /> <br />lq;we you ever been part of a fire departfnent or rescue squad? Yes <br />If yes, where and~ when? 34 · r--~c',_~ 00- :~ % <br /> <br />No <br /> <br />List an)' special Skills or hobbies that you have that ma), pertain to the fire service: <br /> <br />Have you ever b~en convicted of a felon),? Yes No ... ~ <br /> <br />If >,es, explain: , - <br /> <br />Do you consent tO a character investigation? <br /> case. of emergtmcy, notify: <br /> <br />YeS ~< NO <br /> <br />hereby certify that all statements are complete and true to the best of my knowl~ge. <br /> <br />Signature /'~/~.~- ~~e_ Date <br /> <br /> <br />