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APPLICATION FOR MEMBERSHIP <br />CITY OF RAMSEY FIRE DEPARTMENT <br /> <br /> nrst <br /> <br />I1110{11~ <br /> <br />Distance from Permanent Residence to Ramsey City Hall ~ ~;rn~[~c,~ <br /> -755- <br />Areyou 18 yem's or older? YESeS. NO Phone Number (.~)'?~'3 - ~Z - '455B <br />Positiondesffe~ ~/~Lt,tvT~Lel?. ~,' 7/~- Daxeyoucanstart <br /> <br />Have you filed an application here before? YES.~ <br /> <br />Referral Sotmem: Ad Friend Relative <br /> <br />NO ~( If yes, give date <br />Walk-In ~ Other <br /> <br />YES.~_ NO <br /> <br />Are you now employed? <br /> <br />Employer <br />A~ess s~t c~ - <br /> <br />List hou~ av~able <br /> Mort. Tue. W~. ~. <br /> <br />Ple~ provide cu~nt D.L g, Cl~s & Expiation D~: <br /> <br />If yes, please complete the following: <br /> <br />state zip <br /> <br />Fri. Sat. Sun. <br /> <br />License ~..~7 Z~-?Mq-q;~- qr~OClass C- ~ Expiration Date <br /> <br />Related eduCation/experience for fire fighting ©.)~&~_ ~ ~ <br /> <br /> r <br /> <br />PERSONAL REFERENCES <br /> <br />Please list 3 People you have known for at least 1 year not related to you. <br /> Years <br />Name Address Phone Occupation Acquainted <br /> <br /> / <br /> <br />I ~o~ ~v~g~on of ~ ~ ..... men~ cont~ ~ ~ ~plicafion ~ may ~ necess~' to de~e <br />e~bi~ty fg mem~mMp. I c~ ~at ~we~ Wen hem~ ~ ~e ~d complete to ~e ~m of my <br />~owl~ge md I ~de~d ~ ff ~epmd, f~ s~emen~ on th~ applic~on sh~ ~ ~o~ds <br />for di~. I ~de~d ~d ~e ~ if <cepmd, my mem~mhip is for no de~ite period =d may <br /> <br />Si~ ~ Date <br /> <br /> <br />