Mountain View Volunteer Fire Department

Application for Firefighter Membership

Complete every section as fully as possible. This online form mirrors the department's paper application.

Applicant Information

Full Name

Last 4 of Social Security Number

Physical Address

City

State

Zip Code

Mailing Address

City

State

Zip Code

Home Phone

Cell Phone

Work Phone

Email Address

Date of Birth

Authorized to Work in the U.S.

Emergency Contact

Emergency Contact Phone

List all counties and states lived in during the past 10 years

Sensitive personal entries are still handled through the existing application configuration and encryption flow. No environment variable changes are required for this update.

Driver and Physical Information

Driver License Number

Class Type

State

Weight

Height

Eye Color

Background Questions

Traffic violations within the past 3 years?

Yes No

Previous fire service experience?

Yes No

If yes, list traffic violation(s) and date(s)

If yes, service type

Department Name

Years Served

Department Location

Have you ever been charged with a crime (misdemeanor or felony)?

Yes No

If yes, provide location, charges, date, and outcome

Employment History

List all jobs held in the past 10 years. Put your present or most recent job first.

References

Paper application format retained here with space for multiple personal or professional references.

Education and Qualifications

High School Diploma

GED

Last High School Attended (Name and State)

College or Trade School Attended (Name and Location)

Graduated?

Major / Minor

Degrees Received

Job Related State Level Certifications

Extracurricular Activities, Offices Held, Awards, Honors, Hobbies, or Sports

Applicant Certification

The applicant must provide an updated criminal background report from the Clerk of Court in each county of residence for the last 10 years at the applicant's expense, and a copy of the report must accompany the application.

By signing below, you affirm that the information contained within this application is accurate and authorize the Mountain View Volunteer Fire Department of Catawba County, Inc. to contact references, employers, and other entities to verify the information provided.

Digital Signature

Type your full legal name as your signature.

Date

Resume or Supplemental Pages (PDF, DOC, DOCX, up to 10MB)

Applicant to stop here.