Contact Info:
United Vol. Fire & Rescue
PO Box 115 East McKeesport PA 15035
(412)823-9654
Online Membership Application
Name:
Address:
City:
State:
Zip:
Telephone:
E-Mail:
Sex:
Male
Female
Date of Birth:
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Restrictions:
Have you ever been convicted of a crime?
No
Yes
If so, give details:
What service(s) would you be interested in providing?
Fire
Rescue
EMS
Support
Do you have any previous emergency experience?
If so, please list certifications and details:
Please list three (3) people, not related to you, who can provide a character reference:
Name
Address
Phone
Relationship
1
2
3
In case of emergency, please notify:
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Relationship:
Beneficiary:
By clicking the “Submit” button below, I am hereby making application for membership in the United Volunteer Fire & Rescue Company. I give permission for UVFR to conduct an investigation into my background, and if accepted, promise to uphold the bylaws of the Company and to obey the officer in charge at any emergency scene or other Company function.
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