First Name(Required) Middle Name(Required) Last Name(Required) Address(Required) Street Address Address Line 2 City - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Social Security Number How long have you been at this address?(Required) Phone Number(Required)Email(Required) Present Employer(Required) Date of Birth(Required) MM slash DD slash YYYY What division are you applying for?(Required)- Select -FirefighterFire PoliceSupport StaffHave you ever been convicted of a felony?(Required)YesNoWhat charge? This is confidential(Required) Lancaster Township Fire Department - Confirmation #1(Required) I understand that the Lancaster Township Fire Department was organized to protect the community from destruction by fire, storm, and natural disaster and in service to the community I will be giving of my time to public service and that public service is the duty of every citizen. Lancaster Township Fire Department - Confirmation #2(Required) I understand that the Lancaster Township Fire Department is not a social club and that I will be required to give of my time to respond to emergency calls, training sessions, meetings, fund raising functions, work details, and any other projects of this fire department. Lancaster Township Fire Department - Confirmation #2(Required) I understand that I must submit a valid PA Child Abuse Clearance within 30 days of receiving an email request containing the necessary information for the clearance. The Lancaster Township Fire Department will cover the cost. Failure to submit the clearance may result in dismissal of this application. Lancaster Township Fire Department - Confirmation #3(Required) I understand that any aspect of my background that is detrimental to the welfare of the Lancaster Township Fire Department is grounds for rejection of this application. Lancaster Township Fire Department - Confirmation #4(Required) I understand that if my application is accepted by a vote of the membership committee that I will be granted a one hundred and eighty (180) day probationary period and that my membership is contingent upon a vote of the membership committee at the end of the one hundred and eighty (180) day probationary period. Lancaster Township Fire Department - Confirmation #5(Required) I understand that my membership can be revoked at anytime by a vote of the Officers of the Lancaster Township Fire Department for any misconduct or for any willful disobedience of a legitimate order of any officer of the Lancaster Township Fire Department in accordance with the Constitution and By-Laws of the Lancaster Township Fire Department or the Standard Operating Guidelines of the Lancaster Township Fire Department. Fire Service Experience: (List Past Fire Companies and Training)(Required)Character References: (Other than Fire Department members and Relatives)(Required)NamePhoneAddress Add RemovePlease provide three references.Sponsored by: Why do you wish to join the Lancaster Township Fire Department?(Required)If accepted as a member of the Lancaster Township Fire Department, what are your goals?(Required)Lancaster Township Fire Department - Application Accuracy Confirmation(Required) I hereby swear that all information in this application is true and correct to the best of my knowledge. CAPTCHA Δ
