APPLICATION FOR MEMBERSHIP:

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970.340.7040
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Volunteer Application

APPLICATION FOR MEMBERSHIP:

First Name (required)

Last Name (required)

Full Address

Street Address 1

Street Address 2

City

State

Zip

Mailing Address

Street Address 1

Street Address 2

City

State

Zip

Home Number

Cell Phone Number

Work Phone Number

Email (required)

Training

Have you ever had any prior training or experience in firefighting or emergency medical services?

Yes

No

If firefighter, current level:

FF1

FF2

Other:

If medically trained, current level:

AFA

CPR

EMT-B

EMT-I

EMT-P

Other:

Current State in which you are certified and expiration date:

Additional training:

MAST

IV

ACT

ACLS

Extrication

Other training:

1. Have you ever been a member of another fire department or fire protection district in the state of Colorado or elsewhere?

Yes

No

2. Have you previously served as a volunteer or paid staff member with this Authority?

Yes

No

3. When did you join?

4. When did you resign?

If you are accepted as a member, it will be your responsibility to supply our department with documentation from your previous fire chief(s) of your dates of service, as well as your training hours and any additional non-confidential information pertaining to your qualifications and credentials.

5. List any foreign languages you speak:

6. Briefly explain why you want to join the department:

Please list three (3) local references:

Reference 1

Name

Address

Phone

Reference 2

Name

Address

Phone

Reference 3

Name

Address

Phone

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Date (mm/dd/yyyy) (required)

File Upload

Are you 21 or over?

Yes

No

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1089 J W Dr, Carbondale CO 81623

Telephone (970) 340-7040

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Website Accessibility Statement

Roaring Fork Fire Rescue (the "District") is committed to ensuring that its services are accessible to all members of the public. As part of this commitment, the District strives to provide an accessible website compatible with the Web Content Accessibility Guidelines (WCAG) version 2.1, AA, and commercial screen reading software. Features of the website are created to allow individuals with vision and other impairments to understand and use the website to the same degree as someone without disabilities.