CVFC E-Application. NOTE: If not filled out completely form will be deleted

Indicates Required Field

Membership Type: Select Type of Membership		Active Member Association Member Junior Member (16 to under 18 )
Name: Name
Address:
Age:
Date of Birth:
Place of Birth:
Best Contact Phone:
Email Address:
New Jersey Driver License :
Resident of Chester for::
Military Service Y/N::
Type of Discharge::
Sign:		Check Here if you agree to below I, ___________________________________, hereby make application for membership in the Chester Vol Fire Co #1 and agree to be governed by it's by-laws as long as I may be a member thereof. If applying for active membership I understand I will be enrolled in the NJ State Fireman's Relief Association and that my physical must be completed and the paperwork turned into the Secretary of the relief association no later than 30 days after being accepted into the company. I understand that once no longer a member of the Chester Volunteer Fire Company (CVFC), either through resignation or expulsion, I will return ALL property of the CVFC’s within 30 days. This includes but not limited to: Personal Protective Equipment, Electronic Notification Equipment, Radios, ID’s, Key Cards, Blue Light Permits, Items Borrowed from the Fire Company, and pay any debts. In addition to the above, I agree to remove markings and lights from personal vehicles that might unintentionally identify myself as a member of the CVFC.