Join Us

As this agency is entirely staffed by volunteers we rely upon members of the community for staffing. With the increase in demands from work and family commitments, new members are always welcome and needed to help provide these services to the community. Not every member is an interior firefighter. There are ample opportunities for those who don't want to go into burning buildings to offer a hand. Members are needed to drive apparatus, run the pumps, fill air bottles, direct traffic, give medical attention, and provide other vital support operations. We also have a need for EMS members and associate members. These members would contribute to our company in many varied ways.

Our members range from 16 year old Junior Firefighters to retired personnel of more sophisticated age. Many of our members have gotten involved, planning on only taking a small part in fire fighting operations and as time has passed, have discovered the desire to further their skills. Several firematic and/or EMS members have moved on to positions with paid fire departments, locally like the Binghamton and Endicott Fire Departments to a more national level with the Washington DC Fire Department. Other members have gone into jobs in the private sector with national organizations like the Insurance Service Organization, ISO, which provides guidelines for fire fighting and insurance regulations. We encourage anyone who may have even a slight interest in becoming a firefighter, EMS provider, or in just volunteering their time to more value our community to stop by and explore the opportunities provided by becoming a member.

Anyone interested in becoming a member must complete a written application and be interviewed by the Board of Directors. For firematic and/or EMS members a physical exam will must be conducted. The applicant is then presented for membership and when accepted goes through a probationary period where they become familiar with the duties and requirements of membership. Anyone interested in joining is welcome to visit Station 1 located at 17 Kattelville Road any Monday night between 7-9pm.

MEMBERSHIP APPLICATION

Fire Fighter/EMS: EMS only: Associate:

Applicant

First Name:

Last Name:

Middle Initial:

Home Phone:

Cell Phone:

Email:

Present Address:

City:

State:

Zip Code:

Mail Address:

City:

State:

Zip Code:

DOB:

Sex:

Height:

Weight:

Eye Color:

Hair Color:

Racial Appearance:
White Black Am. Indian Japanese Chinese Other

Skin Tone:
Light Medium Dark

Military Service:
Yes No

Branch /Years of Service:

Place of Birth:

Drivers License Number:

State:

DL Class:

Marital Status:

Maiden Name:

Spouse Name:

EDUCATION

Please check one of the following:
High School Some College College Graduate Graduate Studies

High School Attended:

College Attended:

Highest Grade / Degree Earned:

LAW ENFORCEMENT AND MEDICAL RECORDS

Do you object to a law enforcement agency review of this application by means of a records check?

Have you ever been convicted of a crime?

Have you ever been habituated or addicted to stimulants, depressants, narcotics, alcohol, or any other substances that may alter your judgment or behavior?

Do you have any disabilities, physical impairments, or health related problems which would limit your activity in the fire company?

If so, what?

CHARACTER REFERENCES

(3 references are required and they should not be family members and they should be known at least two years)

Name:

Address:

Phone:

Time Known:

Name:

Address:

Phone:

Time Known:

Name:

Address:

Phone:

Time Known:

TRAINING

Have you ever belonged to a Fire Company?

When?

Name of Fire Company

Chief

Previous Experience:
Fire EMS Rescue Medical Law Enforcement

Positions / Offices held

Have you ever completed Basic Fire Fighter?
Yes No

Date

Please list any other Fire or EMS courses or training you have completed and the date of completion

Do you have any other fire or EMS experience you feel would be important?

REASON FOR VOLUNTEERING

OCCUPATION

Employer

Business Address

Phone

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

NOTICE

(Penal Law, Section 210.45)

It is a crime punishable as a class A misdemeanor under the laws of the State of New York for a person, in and by a written instrument, to knowingly make a false statement, or to make a statement which such person does not believe to be true.

By the applicant entering their name in the box below, they are electronically signing this application and it carries the same legal value as if it were signed by the applicant in person.

Signed:

Consent and Release By Individual

I, , residing at , , New York, hereby request, authorize and direct that the Chenango Bridge Fire Company, Inc., its officers, members and/or designee conduct a review of any and all records regarding me as it pertains to a background investigation for membership in the Chenango Bridge Fire Company, Inc. to include, but not limited to, a criminal history and arson check to be conducted by a local law enforcement agency.

I acknowledge, understand and agree that the accuracy of any said information is not subject to the control of the Fire Co.

Further, I do hereby release, remise and discharge the said Fire Co. its officers, and/or members of and from any and all causes of action, suits, claims, liability, damages, and any I have or which my legal representation or future grantees of title shall or may have by reason of matter, action, failure to act or think whatsoever and particularly, but not limited to, the acts or omissions of the Fire Co. in regard to this consent and release.

Signature:

Maiden Name:

Date of Birth:

Chenango Bridge Fire Company

Bravely serving the Town of Chenango in Binghamton, New York since December 1938

Membership Opportunities

MEMBERSHIP APPLICATION

Applicant

EDUCATION

LAW ENFORCEMENT AND MEDICAL RECORDS

CHARACTER REFERENCES

TRAINING

REASON FOR VOLUNTEERING

OCCUPATION

NOTICE

Consent and Release By Individual

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