Blount County Rescue Squad - Adult Application

Page 1 of 9 - Page 1 - Personal Information

11%
Which position are you applying for? *
Comprehensive Rescue - (24-hour per month minimum time commitment) You may also train and participate on specialty teams below. Dragon Team Only Search and Rescue Only Water Rescue and Recovery Only Support Team Only
How did you hear about this opportunity? *
Local Newspaper Radio Station PR / Recruiting Event Walk-In BCRS Website Online BCRS Member
If you were referred by a BCRS member, what is their name?
Have you ever applied for membership with the Blount County Rescue Squad? *
Yes No
Do you have any relatives currently involved with the Blount County Rescue Squad? *
Yes No
If so, what is their name?
PERSONAL INFORMATION
Today's Date: * / MM / DD YYYY
Name * First Last
Nickname
Date of Birth: / MM / DD YYYY
Current Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email Address: *
Phone * - ### - ### ####
How long have you been at the above address: *
Do you currently hold a Tennessee Drivers License? *
Yes No
If Yes, Please enter your driver's license number:
Prior Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Are you a United States Citizen? *
Yes No
Are you over the age of 18? *
Yes No
Are you legally eligible for employment in the United States? *
Yes No
What date would you be able to start? * / MM / DD YYYY
How many hours per week would you be able to dedicate to Blount County Rescue Squad? *