CVFD Application
Thank you for your interest in the Cornwall Volunteer Fire Department. Our organization is one in which integrity is paramount. Our reputation is directly related to the code of conduct displayed by each of our members. Our members interact directly with the public and it is important that they be concerned for the safety and welfare of the public at all times. Therefore, please be aware that we will thoroughly scrutinize the information that you provide on the membership application. We do this in an effort to provide the citizens of the Town of Cornwall with individuals who will uphold the excellent reputation of the Cornwall Fire Department.

After receipt of the applicant will be presented at the next monthly meeting. Following that meeting and a reference check, an interview with applicant will be scheduled with the Standing Committee. If the application is approved by the Standing Committee, the membership will vote on the applicant's membership at a subsequent meeting. This process often takes up to two months.
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Email *
Name *
Street Address *
Mailing Address *
Town, State, Zip *
Telephone *
License # *
What are you interested? Check all that apply *
Required
Do you have previous Fire Department experience? *
If yes, please list all departments and the chief's name and number
Current occupation
High School education
College
Military
Please explain any relevant life experience.
Fire Department Sponsor (name, phone number, relationship) *
Community reference (name, phone number, relationship) *
Work reference (name, phone number, relationship)
Teacher reference (if a student, name, phone number, relationship)
Should we be aware of any medical conditions or physical disabilities?  (note physicals are required) *
I hereby certify that I have not knowingly withheld any information that might adversely affect my service and that the answers given by me are true and correct to the best of knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any documents used to secure my services shall be grounds for rejection of this application. Initial below. *
I hereby authorize the Cornwall Volunteer Fire Department to thoroughly investigate my references, work record, education and other matters related to my suitability for service and further, authorize the references I have listed to disclose to the department any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the department, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigations or disclosure. Initial below. *
I understand that nothing contained in the application or conveyed during any interview which may be granted or during my service if selected is intended to create a service contract between me and the Cornwall Volunteer Fire Department. Initial below. *
Electronic Signature *
Date *
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