Firefighter Volunteer Application SECTION A: NAME AND CONTACT INFORMATION First Name* Last Name* Home Phone Cell Phone (Required for IAM Responding Call Out App)* Cell Phone Provider (e.g. Telus, Bell, Rogers)- Required for IAM Responding Call Out App* Email* (Required for IAM Responding Call out App) Mailing Address Address Line 1 Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukonNunavutNorthwest Territories Postal Code Country Apex Mountain Physical Address (For Apex Part-Time or Full-Time Residents) Address Line 1 Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukonNunavutNorthwest Territories Postal Code Country SECTION B: EDUCATION, SKILLS AND PREVIOUS EXPERIENCE A wide range of skills are required to effectively operate a modern fire and rescue organization. Please provide the education and/or skill set(s) that you are willing to offer in supporting the operations of the Apex Fire Brigade Society Please select all skills that apply, or provide additional skills in "other" Animal Health TechAnimal RescueBuilding InspectionCarpenterChainsaw Operator/ FallerChemist/ Chemical EngineeringCoachingConstructionDisaster Response/ ManagementElectricianElectric UtilityFire AlarmsFire InspectionFire Sprinkler SystemsFirst AidForestry/ ForesterGas FitterGas/ Propane UtilityHazMatHeavy Equipment OperatorMechanic/ Vehicle RepairMillwrightNursingParamedic/ EMAPipefitterPlumberProfessional DriverPublic RelationsPsychology/ CounsellingRefrigeration SystemsSmall Engine RepairStructural Engineer/ Structural DesignStructural FirefighterSwiftwater RescueRope Rescue/ Rope Access/ Rock Climbing/ Alpine ClimbingTeacher/ InstructorUrban RescueVehicle ExtricationWildland Firefighter Other Skill(s) SECTION C: VOLUNTEER FIREFIGHTER JOB DESCRIPTION I am applying to volunteer as a firefighter and have read the volunteer firefighter job description CLICK HERE TO READ THE VOLUNTEER FIREFIGHTER JOB DESCRIPTION I am applying as a volunteer firefighter and have read the volunteer firefighter job description. YesNo You must answer all of the basic firefighter questions in Section C of this form. Do you understand that you have the right to refuse any work or task that you perceive as unsafe, or you are not physically capable of safely performing while undertaking your duties as a volunteer AFBS member?* YesNo Are you willing to always make safety your first priority while undertaking the duties of a volunteer firefighter?* YesNo SECTION D: BASIC FIREFIGHTER REQUIREMENTS Do you live full-time, year-round within the Apex village?* YesNo- I reside part-timeNo- I do not have a residence at Apex If you live part-time at Apex, how many days per year are you typically here? If you live part-time at Apex,what months are your typically here? Do you work at Apex Mountain Resort* Do you believe that you are free of medical conditions that may preclude your participation as a volunteer firefighter and undertake the duties of a volunteer firefighter as described in the job description?* YesNo CLICK HERE TO READ THE VOLUNTEER FIREFIGHTER JOB DESCRIPTION Are you willing to complete a self-declaration for medical fitness? * YesNo Are you willing to undertake a vulnerable population criminal record check?* YesNo Do you have a current BC Class 5 non-restricted driver's licence?* YesNo Do you have a current BC Air Brake Endorsement?* YesNo The minimum requirement to become an AVFR firefighter, is the exterior attack firefighter qualification. Due to the investment in training and equipment for each exterior attack firefighter, AVFR requires a minimum 2-year commitment. Can you commit to AVFR for 2 years as a minimum exterior attack firefighter?* YesNo Are you willing and able to participate in a 2.5-hour practice session on the first and third Tuesday of each month, and the occasional weekend fire training program to qualify as an exterior firefighter?* YesNo Following your first year with AVFR you are eligible to continue with advanced training to become qualified as an interior attack firefighter. Interior firefighters will undergo an internal selection process. Due to the investment in training and equipment for each interior attack firefighter, AVFR requires a minimum 3-year commitment. Can you commit to AVFR for 3 years as an interior attack firefighter? YesNo If you are selected for the interior fire attack program, are you willing to and able to participate in a weekly 2.5-hour practice, and 4 weekends of fire training to qualify as an interior attack firefighter?* YesNo There is a significant increase in physical demand as an interior firefighter. As part of the selection process for the interior fire attack program, are you willing to undergo enhanced medical fitness and physical fitness evaluation? YesNo Do you understand that in order to be available for emergency callouts, you must be able to arrive at the fire station promptly and not be under the effects of alcohol and drugs? YesNo Are you willing and able to install the I Am Responding application on your mobile device and respond to emergencies 24 hours per day, 7 days a week, 365 days a year? YesNo Please place a check mark next to the times that you are typically at Apex and available to respond to emergencies: Midnight to 6 AM 6 AM to 6 PM 6 PM to Midnight Sunday Yes Yes Yes Monday Yes Yes Yes Tuesday Yes Yes Yes Wednesday Yes Yes Yes Thursday Yes Yes Yes Friday Yes Yes Yes Saturday Yes Yes Yes Do you understand that volunteer firefighters are expected to be in good physical condition to accomplish the tasks listed in the job description? YesNo Are you 19 years of age or older? YesNo Do you understand that successful applicants are required to remain without facial hair to ensure a self-contained breathing apparatus mask will form a positive seal on the face?* YesNo Are you willing to follow the Apex Volunteer Fire Rescue (AVFR) policies, training standards, directives, and standard operating guidelines?* YesNo Are you willing to follow the Apex Volunteer Fire Rescue (AVFR) chain of command structure and follow direction provided by the Fire Chief or designate supervisor?* YesNo SECTION E: SIGNATURE Please read carefully: I, the undersigned, apply to enroll as a volunteer recruit member of the Fire Department and, if accepted, undertake to perform such duties as may be assigned to me by the Board of Directors and/ or Fire Chief or delegated representative. I understand that this is a volunteer position with a paid-on call firefighter renumeration structure. I understand the promotional opportunities will depend upon positions becoming available, the results of work performance, training evaluation, the recommendation of Fire Officers and approval of the Fire Chief. I verify that the information contained on this application form is true and accurate. I hereby give consent to the Apex Fire Brigade Society to conduct verification of the information given, as required. I agree to the above