Auxiliary Membership

Auxiliary membership is designed for those looking to volunteer their time in support of the White Hall Volunteer Fire Department without the desire to respond to emergencies. To apply, fill out the application below and visit us on the first Tuesday of any month to attend our monthly business meeting and introduce yourself.

opportunities

Auxiliary members help with fundraising for the fire department along with public relations and much more! As an auxiliary member, you are not required to attend weekly firefighter trainings, but may still take on responsibilities within the department.

Auxiliary Application

Name

Please Provide Full Legal Name (Include Middle Name in First Name Box)

First Name

Last Name

Date of Birth

YYYY

Permanent Address

Please Provide An Address That You Receive Mail Regularly

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Local Address

If You Have A Temporary Address That Differs From Your Permanent Address Please Include That Here

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone

(###)

###

####

Cell Phone Provider

If Your Primary Phone Is A Cell Phone Please Provide The Name Of The Service Provider

Phone (Other)

If You Have A Secondary Telephone That You Use Regularly

(###)

###

####

Please Provide An Email You Check Regularly

Any Other Legal Name

If You Have Ever Been Legally Known By Another Name Please Provide That Name

First Name

Last Name

Have You Ever Been Convicted Of A Misdemeanor, Felony, Or Violation As An Adult?

Misdemeanor

Felony

Traffic Violation

Traffic Accidents

Other

None

Please Provide A Description Of All Of The Above (If Applicable)

(Include The Year Of Occurrence)

Have You Ever Applied To The White Hall Volunteer Fire Department Previously?

If So Please Provide The Year And A Brief Description Of The Outcome Of That Application

List Any Previous Experience, Certifications, Military Experience, Or Other Training You Have Acquired That Pertains To Our Field Of Work

(Include Expiration Dates, Years of Experience, and Rank, If Applicable)

Provide Your Highest Level Of Education

Current Employment

(Company Name, Years With Company, Position, Company Phone Number, and Company Address)

May We Contact Your Employer?

Yes

Please Provide Three Personal References (Not Employment Based)

(Name: Phone Number, Relationship)

Please Type Your Full Legal Name Below

(This Will Act as your Signature for Submission of Application)

Date of Application

YYYY

For more information on how to become an auxiliary member, visit us on Tuesday nights at 7:00 pm before training, messaging us on Facebook, or by contacting us at 859-626-5144.