LVFD Membership Application Checklist

·        All Applications

_        New member application

_    Photocopy of Driver's License

_    Release form - allowing LVFD to obtain a copy of your driving record and to perform a criminal background check.

_        Copies of HEP-B shots or signed declination http://www.osha.gov/SLTC/etools/hospital/hazards/bbp/declination.html  

_        Copy of current medical release or agreement to take LVFD provided physical

_        Copy of current Scott Mask fit-test or agreement to take LVFD provided fit test

·        Volunteer Members

_        Orientation Check-off Sheet 

·        Junior Members

_        Parental consent form

_        Durham Tech’s “Authorization Form for Concurrent Enrollment

·        Adult Volunteer Members

_        Copy of high school diploma or GED

_        Completed NC Certification Application
http://www.ncdoi.com/OSFM/FireAndRescueCommission/Documents/Certification/CertificationApplication.pdf

·        Part-Time (Paid Firefighter)

_        Copies of Firefighting and EMT certifications

_        Copies of NIMS certifications (100, 200 and 700)

·        Part-Time (Paid Firefighter) prior to start of work

_        W-4    http://www.irs.gov/pub/irs-pdf/fw4.pdf

_        NC-4    http://www.dornc.com/downloads/nc-4.pdf

_        I-9 http://www.uscis.gov/files/form/I-9.pdf with copies of driver's license and Social Security card.

_        Copy of a voided check and an e-mail address (for setting up direct deposit)

·        Recommended (but not required)

_        VFIS beneficiary form http://www.vfis.com/pdf/BENEDESI2_000.pdf

_        NCSFA beneficiary form
http://www.ncsfa.com/pdf/accident_health_beneficiary_designation_form.pdf

 

 

LVFD Home