Chesterfield Rescue Squad

103 Cotton Street, Chesterfield South Carolina

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Driver's License Number / State *

Reference 1 - Name / Phone Number / Relationship *

I will not talk bad about the fire department in any way. *

Yes

Current Working Hours. *

Reference 2 - Name / Phone Number / Relationship *

I will participate in all training exercises / trainings. *

Yes

Reference 3 - Name / Phone Number / Relationship *

I will take all of the REQUIRED FIRE DEPARTMENT TRAINING. *

Yes

Address *

Name: *

Highest Military Rank

I will remain on duty when answering a call, and will RETURN TO THE STATION unless excused by the OFFICER IN CHARGE. *

Yes

I WILL ATTEND THE FIRE DEPARTMENT MEETINGS EVERY 1ST AND 3RD TUESDAY OF EVERY MONTH. *

Yes

Phone *

I WILL NOT BE ON A FIRE WHILE DRINKING. *

Yes

TEALS MILL RURAL FIRE DEPARTMENT APPLICATION

Current Occupation *

I have past Military Experience (if Yes please put highest rank) *

Yes

I will OBEY all commands of the OFFICER IN CHARGE. *

Yes

I will help with all fund raising projects. *

Yes

Social Security Number

Date of Birth *

Email *

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I understand that if I MISS MULTIPLE FIRES AND MEETINGS (UNLESS EXCUSED BY THE CHIEF/OFFICER) that I am no longer a firefighter for the Teal's Mill FD and will turn in all equipment issued to me. *

Yes

I will go to all fires as much as possible. *

Yes

Thank you for contacting us! Your application has been submitted.

I certify that the above information in this application is true, complete, and correct to the best of my knowledge. I understand that false information may be grounds for rejection of my application. I will sign my application at the meeting date and time I am given by a representative from the Teals Mill Rural Fire Department to confirm all information is correct / unaltered. *

I AGREE

I DO NOT AGREE

I will no use profanity while at a fire, meeting, or function that I am attending with the Fire Department. *

Yes

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