APPLICATION FOR
MEMBERSHIP
[Print
out, complete, and submit to an Asst. Chief or the Borough Clerk]
I,
[print name]
, employed by or residing at
[address]
,
in the Borough of Rockleigh,
New Jersey, hereby apply for membership in the Rockleigh
Volunteer Fire Department on
[date]
,
200 .
I have supplied the information requested on the reverse side of this
application. To the best of my knowledge, I have no health condition(s) or
physical defect(s) which might interfere with the fulfillment of the
duties incumbent upon a fireman in the performance of his or her duties,
except as noted here:
[none or specify]
.
[Form
AP-1]
Approved by the
Executive Committee of the Rockleigh Fire Association:
Date:___________, 200__.
________________________, President
________________________________, Chief
________________________, Secretary
Approved by Resolution of the Borough Council:
Date:___________, 200__.
_______________________,Borough Clerk
