Galiano VFD Application Form
The information on this form will be used to assess your application to a volunteer position with the North or South Galiano Fire Department. The information will not be made public.
Email address *
Date of Application *
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Name *
Street Address *
How long have you been a resident of Galiano? *
Phone *
Date of Birth *
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I would like to volunteer as
Clear selection
Is your ability to perform firefighting or first-responder duties likely to be affected due to a current or previous illness or disability? *
If the above response is yes, please provide details.
Could you generally respond to emergencies during the weekend? *
Could you generally respond to emergencies at night and during weekdays? *
Do you have a valid BC drivers license? *
What classification drivers license do you have? *
Do You have an air brake endorsement on your license *
Have you ever been a member of a fire department before? *
If yes give details.
Present or past employer
May we contact your employer?
Clear selection
If yes, please provide contact info for your employer.
Level of education
Clear selection
Please provide details of any experience you think would be applicable to a role with the fire department.
I understand that on acceptance of this application, the fire department administration will require I provide the following information: my SIN, PHN, a copy of my driver's license, a copy of an additional piece of photo ID, tax return information and banking information for direct deposit of the yearly stipend and a completed Police Record Check. *
By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
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