Laserfiche WebLink
APPLICATION FOR MEMBERSHIP <br />CITY OF RAMSEY FIRE DEPARTMENT <br /> <br /> Griffin David Lowel~ <br />Name <br /> l-,t' f~=st middle <br /> <br />Permanent Addres.~ 14125 Argon ST. NW Ramsey MN 55303 <br /> <br /> street city sm~e z~p <br /> <br />Distance from Permanent Residence to Ramsey City Hall? 1.5 Miles <br /> <br />Areyou 18 years or older? 'xES X NO Phone Number (612) 427 6222 <br /> <br /> Fire Chief Immediate <br />Position desired Date you cmn start <br /> <br />Have you filed an application here before? YES X NO If yes, give dam August 1988 <br /> <br /> Elected By Fire Fighters <br />Referral Source: Ad~ Friend Relative. Walk-la-- Onher <br /> <br />Arc you now employed? YES. <br /> purchasing Agent <br /> <br />X <br /> <br />NO <br /> <br />I[ yes, please complete the following: <br /> <br />Occupation <br /> Altron Incr (612) 427-7735 <br />Employer phone number <br /> 6700 Industry Avenue ~4 Ramsey MN 55303 <br />Adckcss street city stau: zip <br /> <br />List bouts available <br /> <br />4:00pm-6:00am - Mon.-Fri./Occasionally 24 hrs. (Mon.-Fri,)/24 hrs. Sat, <br /> Wed. Trim. t;ri. Sm. Sun.. & Su~ <br /> <br />Plemse Provide currend DJ-. #, Class & Expiration Date: <br /> <br />License ~ .G-615-~135-551-678 Class C <br /> <br />Exph-afion Date August 1992 <br /> <br />Related education / experience for fxe fighting <br /> <br />See Attached Resume. <br /> <br />Acquainted <br /> <br />PERSONNEL REFERENCES <br /> <br />Pl~ase list 3 l~ople you ,have known for at least 1 year not related to you. <br /> <br />Name Address Phone # <br />Steve Wilson .: "-7809 '- 158th Avenue NW Ramsev, MN 421-6159 2 Yrs, <br />A1 Phillips Andover, MN 427-7735 6 Yrs. <br /> <br />Waldo Hasse 586 108th Avenue NW Coon Rapids~ MR 757-4209 6 Yrs, <br /> <br />! authoriz~ investigation of ali statements contained in this application, as may be nac~sary to demrmine eiigibiiity for <br />membership. I certify that answers given herein are true and complete to the bast of my k~owlefige and I understand that, <br />if accepted, falsified statements on this application shall be grounds for dimnissal. I understand and a~ that, if accepted. <br />my membership is for no definite period any may be terramatexl at any time. <br /> <br />Signature Date <br /> <br /> <br />