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RAMSEY FIRE DEPARTMENT <br />APPLICATION FOR MEMBERSHIP <br /> <br />Address /7n ~.~ P: r~,,ss;u/~ <br />Street <br /> <br />Phone No. 75'._.~ - o~V~c~f' <br />Are you over age 18.'? Yes r'~ No <br /> <br />First <br /> <br />City / State <br /> <br />Middle <br /> <br />Zip <br /> <br />Are you under 65? Yes ~ No <br /> <br />EMPLOYMENT: <br />Present Empl6yer /'~(,,f/ D,44,4¢ .r <br /> Name <br /> <br />Position Ga~,',~ c'7' <br /> <br />Working Hours 7 ,'¢¢' ,4/,,") <br /> <br />to 3:3 ~' PrO <br /> <br />Could you leave work to respond to a fke? <br /> <br />Could you obtain written authorization to leave work? <br /> <br />/( 7 <br /> Address <br /> <br />Yes ,H No <br />Yes .,'~", No__ <br /> <br />EDUCATION: <br /> <br />High School . <br /> <br />Name of School <br /> <br />College or <br />Trade School ~ rn/3f~y <br /> <br />Other Special <br />Training <br /> <br /># of Years Attended <br /> .3 <br /> <br />No applicant testing positive for <br /> <br />nicotine shall be accepted <br /> <br />for membership. <br /> <br /> <br />