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FOR OFFICIAL USE ONLY APPROVED CALL SIGN ASSIGNED SHIFT ASSIGNED DISAPPROVED REASON APPLICANT NOTIFIED DATE MEMBERSHIP COMMITTEE. SIGNATURE OF APPLICANT NOTE Members of the Volunteer Fire Service are personally responsible for any equipment issued to him/her. MONTGOMERY COUNTY VOLUNTEER FIRE SERVICE District APPLICATION FOR MEMBERSHIP PLEASE PRINT DATE OF APPLICATION NAME LAST FIRST MI ADDRESS STREET HOME PHONE CITY STATE WORK PHONE ZIP EMAIL SOCIAL SECURITY -- AGE DATE OF BIRTH // MM MALE...
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If applicable, provide information about your previous involvement in fire prevention programs or firefighting organizations.
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