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APPI,ICATION FOR MEMBERSHIP <br />CITY O!:' RAMSEY FIRE DEPARTMENT <br /> <br />IrnO01 e <br /> <br />/'0N 5-5'3o~ <br />statc zip <br /> <br />Are you 18 years or older? <br />Position desired . ,,~-/,,--~ <br /> <br />YEs <br /> <br />Phone Number ( b <br /> Date you can start <br /> <br />Have you filed an application here before? YES NO '2{ If yes, give date <br /> <br />Referral Source: Ad~ Friend Relative.. Walk-In X. Other <br /> <br />Are you now employed? <br />~opaa_ u!~C',r- <br />Occupation <br /> <br />Employer <br /> <br />Adaress street <br /> <br />List hours available <br /> <br />YES X NO.__ If yes, please complete the following: <br /> <br />city state zip <br /> <br />(55:30~,r'-,. To <br />Mon. Tue. Wed. <br /> <br />Thus. Fri. Sat. Sun. <br /> <br />Please provide current D.L. #, Class &. Expiration Date: <br /> <br />License # F. 7?,zo..~ ~ 7- O, ~--ggX' Class <br /> <br />Related eduction/experience for fire fighting <br /> <br />PERSONAL REFERENCES <br /> <br />Expiration Date <br /> <br />Please list 3 People you have lmown for at least 1 year not related to you. <br />Name <br /> <br />Address Phone <br /> <br /> Years <br />Occupation Acquainted <br /> <br />I <br /> <br />I authorize investigation of all statements contaified in this application as ma5' ~ necessary to determine <br />eligibility fo? membershio. I cerri~' that answers given herein are true and complete to the best of my <br />Imowledge and I understand that. if accepted, falsified statements on this application shall be grounds <br />for dismissal.. I tmdersmd and agree tha:. if accepted, my membership is for n o dePmit e period and ma>, <br />be term~~.~y time. <br /> <br /> <br />