Membership ApplicationApplicant InfoMembership Preference Firefighter - must be a minimum of 18 years of age, must be resident of Hightstown or East Windsor for the six (6) months prior to acceptance and a citizen of the United States of America Fire Police - must be at least 18 years of age Associate Member - for those persons who express a desire to help the Company other than as an active Firefighter or Fire Police. Junior Member - must be between 14 and 17 years of ageFirst Name Last Name Birthdate AddressAddress Line 1 City State Zip Code Email Phone Number (Numbers ONLY, no hyphens, parentheses, or spaces) Driver's License # Has your driver's license ever been suspended? Yes NoPlease explain Do you have any special endorsements on your Driver’s License? Bus Articulated Heavy Equipment OtherPlease enter Other endorsements Have you ever been convicted of a crime? Yes NoPlease state the circumstances Place of Current Employment AddressAddress Line 1 City State Zip Code How long been employed here? Normal Work Schedule Job Description ReferencesList three references (Non- Family Members) known for at least one year.First Name Last Name Phone Number (Numbers ONLY, no hyphens, parentheses, or spaces) AddressAddress Line 1 City State Zip Code First Name Last Name Phone Number (Numbers ONLY, no hyphens, parentheses, or spaces) AddressAddress Line 1 City State Zip Code First Name Last Name Phone Number (Numbers ONLY, no hyphens, parentheses, or spaces) AddressAddress Line 1 City State Zip Code Emergency Contact InformationIn case of an emergency, who should we contact?First Name Last Name Day Time Phone # (Numbers ONLY, no hyphens, parentheses, or spaces) Night Time Phone # (Numbers ONLY, no hyphens, parentheses, or spaces) AddressAddress Line 1 City State Zip Code Additional InfoList any hobbies or interests you have, Boating, Fishing, Hunting, Scuba Diving, etc..... Are you an American Citizen? Yes NoHave you served in the armed forces? Yes NoWhat branch of service? Specialized training? Are you currently or have you been a member of another Fire Department? Yes NoDepartment name and dates of service Reason for leaving Is there any information that is not included on this application that you feel we should know about you before we investigate your application? Do you have any concerns with the Hightstown Engine Company #1 Membership Committee, doing a background check on your history? Yes NoPlease elaborate Do you have any problems with random Drug-Alcohol Testing? Yes NoPlease elaborate In short paragraph, explain why you wish to become a member of the Hightstown Engine Company #1 and what you can do for the company and our community. Submit Application