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RAMSEY FIRE DEPARTMENT <br />APPLICATION FOR MEMBERSHIP <br /> <br />N~me AJe.,vlk o n <br /> Lasi <br /> <br /> S Lreet <br />phone ~o. ~/- ~(o/ <br />Are you over age 187 Yes ~ No <br /> <br />Firs t Middle <br /> City / State Zip <br /> <br />Are you under 65? Yes ~<~ No~ <br /> <br />EMPLOYMENT: <br />Present Employer --~ <br /> Name <br /> <br />Position <br /> <br />Address <br /> <br />Working Hours e_~'~o to <br /> <br />Could you leave work to respond to a fke? <br /> <br />Could you obtain written authorization to leave work.'/ <br /> <br />Yes 2~ No <br />Yes /< No.~ <br /> <br />EDUCATION: <br /> <br />High School <br /> <br />College or <br />Trade School <br /> <br />Other Special <br />Training <br /> <br /> Name of School # of Years Attended <br />q~+,-', ~.t,. 4Oe~v, ~;Sb,. ~., ._1,~ <br /> <br />No applicant testing positive for nicotine shall be accepted for membership. <br /> <br /> <br />