Recruitment

Become a Member!

Application For Membership

Personal & Contact Information

First Name *

Middle Name

Last Name *

Date of Birth

Address *

Address

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

Home Phone

Cell Phone

Drivers License #

State Issued

Expiration

Have you ever been convicted of any offense other than a minor traffic violation? *

Yes

If yes, please explain

Name of Emergency Contact *

Relationship *

Phone

Address of Emergency Contact *

Address of Emergency Contact

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

Current Employer

Current Employer Address

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

Supervisor

Supervisor Phone #

Do you have any physical impairment that may interfere with your performance? *

Yes

If yes please explain

Have you ever applied for membership? *

Yes

If yes give aprox. Date

Have you ever been a member of any Fire/Rescue company? *

Yes

If yes give aprox. date.

Department name, phone number & chief's name

List any certifications (Fire & EMS) Attach a copy of each to application

List Three (3) persons not related to you for references

Reference Name *

Phone *

Address

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

Reference Name *

Phone *

Address

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

Reference Name *

Phone *

Address

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

PLEASE READ AND SIGN

I herby authorize Canterbury Volunteer Fire Company Inc., and its membership committee to investigate the statements made of this application. I will abide by the rules, regulations & by-laws set forth by Canterbury Volunteer Fire Company Inc.

Print Name *

Applicant Signature *

Clear

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Parent/Guardian Signature

Clear

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Date *

Date

If you are human, leave this field blank.

	EMS	Fire	MVA	Total Calls	2025 Monthly Totals	Percent Difference
January 2026	43	7	2	52	57	-8.77%
February 2026	46	6	0	52	40	30%
March 2026	47	9	6	62	68	-8.82%
April 2026	47	14	1	62	51	21.57%
May 2026	60	11	6	77	55	40%
June 2026	0	0	0	0	56
July 2026	0	0	0	0	60
August 2026	0	0	0	0	73
September 2026	0	0	0	0	64
October 2026	0	0	0	0	54
November 2026	0	0	0	0	59
December 2026	0	0	0	0	62
Yearly Total	243	47	15	305
2025 Totals	535	119	45	699