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APPLICATION FOR MEMBERSIIIP <br />CITY OF RAMSEY FIRE DEPARTMENT <br /> <br />RECEIVED <br />AUG I 2 1991 <br />An 'd ............ <br /> <br />Distance from Permanent Residence to Ramsey City Hall <br /> <br />mlctQle <br /> <br />state z~p <br /> <br />Are you 18 years or older? YES/-~ NO <br />Position fl~ireA <br /> <br />Phone Number (~; 2._ ) .?~. 5~g'p- ¢' <br /> Date you can, start ,.~/~ ,~w,,e-Y <br /> <br />Have you filed an application here. before? YES NO ~ If yes, give date <br /> <br />Referral Source: Ad Friend Relative .~ Walk-ln~ Other <br /> <br />Are you noW employed? YES ~ NO. <br />~u~tion <br /> <br />If yes, please complete the following: <br /> <br />Employer <br />A&iress strut city state zip <br /> <br />Listhoursavailable ,2,0,,0-2~,a .2,~m-zp~ ~q~re~ 2~/~,,~s 2,0,~-2,~ .2,~r/-?e~, 2,,~,~-2~,~ <br /> Mon. Tue. W~. ~. Ffi. Sat. S~. <br />Plem~ provide cumnt D.L. ~, Cl~s & Expmfion Dine: <br /> <br />License~ ~-X~-OgC-gOl-12~ Cl~s C-O Exp~ionDam <br /> <br />Relined ~ucafio~ex~fience for ~ fighting ~t n~ ~ ~ o <br /> <br />PERSON AL REFERENCES <br /> <br />Please fist 3 people you have known for at least i year not relateA to you. <br /> <br />Name Address Phone Occupation <br /> <br />Years <br />Acquainted <br /> <br /> ~R?N r_/se, ns _5._7.,/33 <br />] .a~thori2e investigation of va! statements contained iv, thzs application as ma5' be necessary to determine <br />~,tgnbmty fOr membership. I cerfifT that answers given herein are true an~. complete to the best of my <br />knowledge and i understand that, ff accepted, falsified statements on this application shall t:e grounds <br />for eli mfis~al. I understand and agree that, ff accepted, my mem~rship is for no definite period and ma3, <br />be te..~inam~, at any .,dme~. ~ , . <br /> <br /> <br />