Welcome Page
*NEW* Donate to the Rescue Squad
History & Tradition
Operations Division
Division of Fire Prevention
Event/Training Calendar
Membership Opportunities
On the Scene Photo Gallery
Rescue Squad, The Movie
W.C.R.S. Fire Stations
Apparatus & Equipment
Department Services
LISTEN LIVE!
TDOT Statewide Incident Map
Fire Safety Inspection Request
Fire/Incident Tip Line
Contact Information
Squad KIDZONE
E-Mail Access
Web Links
Employees Only
Training Calendar
e-mail me
 
Name *
Address *
Home Phone *
Mobile Phone *
E-mail Address *
Social Security Number *
Date of Birth *
Have you ever applied for Squad membership before? * Yes No
If Yes, give date.
Have you ever been convicted of a Felony? * Yes No
If Yes, Explain. *
Do you have a Valid driver's license? * Yes No
If Yes, List state of issuance and number. *
Are you currently Employed? * Yes No
Employer. Beginning with most recent. *
Address *
Telephone *
Job Title *
Duties *
From: *
To: *
May we contact for a reference? * Yes No
Employer
Address
Telephone
Job title
Duties
From:
To:
May we contact for a reference? Yes No
Employer
Address
Telephone
Job Title
Duties
From:
To:
May we contact for a reference? Yes No
High School Attended *
Address *
Did you Graduate? * Yes No
College or University
Address
From:
To:
Degree or Certificate Earned?
Other Skills or Qualifications
Licenses or Certifications (list license numbers & expiration dates, if applicable)
Reference #1 *
Telephone *
Years known *
Reference #2 *
Telephone *
Years known *
Reference #3 *
Telephone *
Years known *
I certify that to the best of my knowledge and belief, all of the information and statements provided by me in and with this application are true, correct and provided in good faith. It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and / or separation if I have been accepted. I give the Williamson County Rescue Squad the right to investigate all references and to secure additional information about me. I consent to the release of information about my ability and fitness for membership by employers, schools, law enforcement agencies and other individuals and organizations. I hereby release from liability the Williamson County Rescue Squad and its representatives for seeking such information and all persons, corporations, or organizations for furnishing such information. True False
Online Signature (Print Name): *
Date *

 

|Welcome Page| |*NEW* Donate to the Rescue Squad| |History & Tradition| |Operations Division| |Division of Fire Prevention| |Event/Training Calendar| |Membership Opportunities| |On the Scene Photo Gallery | |Rescue Squad, The Movie| |W.C.R.S. Fire Stations| |Apparatus & Equipment| |Department Services| |LISTEN LIVE!| |TDOT Statewide Incident Map| |Fire Safety Inspection Request| |Fire/Incident Tip Line| |Contact Information| |Squad KIDZONE| |E-Mail Access| |Web Links| |Employees Only| |Training Calendar|