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*~ APPLICATION <br /> ~ CITY OF <br /> <br />Distance from P~m~t <br /> <br />FOR <br /> <br />RAMSEY FIRE <br /> <br />Are you 18 years or older? YES t// NO <br /> <br />MEMBERSHIP <br /> DEPARTMENT <br /> <br />Position desired <br /> <br />Have you filed an application here before? YES ~ <br />Referral Sorer. e: Ad / Friend Relative <br />Are you now employed? YES / NO <br /> <br /> city <br /> <br /> Phone Number ~ <br /> <br /> Date you can start <br /> <br />NO J If yes, give date <br /> <br /> W~k-I~-- O~er <br /> <br />zip <br /> <br />If yes, please eomplet~ thc following: <br /> <br />phone number <br /> <br />Occupation <br />Employer ' <br />Address saeot <br /> <br />List hours available (~t,. pe..nl)e~,'7' <br /> Mom 'I'ue. <br /> <br /> city <br /> <br />Tam. Fri. <br /> <br />zip <br /> <br />Please Provide currend D.L. #, Class & Expiration Date: <br /> <br />Expiration Date ~ 0 <br /> <br />Related education/experience for fore fighting <br /> <br />PERSONNEL REFERENCES <br /> <br />Please list 3 people you have lmown for at least 1 ye. ar not related to you. <br /> <br />Name Address Phone # <br /> <br /> Years <br /> Acquainted <br /> <br />3 ¥ ,',-,' ,,,o,, <br /> <br />I authorize investigation of ali statements contained in this application, as rrmy be necessary to determine eligibility for <br />membership. I mn.ify that answers given heroin are mae and complete to the bast of my knowledge and ! unde. rs',and hhat, <br />if accepted, falsified statements on this appli:ation shall be grounds for dismissal. I understand mad a~ee that. if a:cepmd, <br />my' membership is for no clef'mite period ~y rrmy be terminated at any time. <br /> <br /> (i ,Ce.\-,,_,,,,.,,,,.,.__ <br />Si~amre ~:- Date <br /> <br /> <br />