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UPPER MONTGOMERY
COUNTY VOLUNTEER
FIRE DEPARTMENT, INC.
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P. O. Box 8
19801 Beallsville Road
Beallsville, MD 20839
301-972-8888
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MEMBERSHIP APPLICATION
FIRE - RESCUE
EMERGENCY MEDICAL SERVICES
REVISED APRIL 2002
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(2) A Brief History of the
Upper Montgomery County Volunteer Fire Department, Inc.
The Upper Montgomery county Volunteer Fire Department, Inc. was organized in 1946 by a group of local dedicated citizens who realized the need for local fire protection. The corporation charter was signed on April 29, 1946 with the intent to serve the communities of Poolesville, Beallsville, Barnesville, Dickerson, and Dawsonville. The cornerstone for the firehouse was laid on July 26, 1947. The building was ready for occupancy in the spring of 1948. The first fire engine was purchased for $8,300.00. The first ambulance was placed in service in September 1953. By 1966 it became apparent that the department would have to employ its first career firefighters during the weekday daytime hours. Today a combination of career and volunteer firefighters and emergency medical personnel staff the department. The department currently operates two pumpers, a tanker, a rescue engine, a dedicated medic unit, an ambulance that can be readily upgraded to a medic unit, two boats, two brush trucks, a command unit, and several support units. Fire/rescue/EMS has changed in the last half century but the mission of the U.M.C.V.F.D remains, "Provide the best possible Fire-Rescue and Emergency Medical Service to the people we serve."
(3) For the Applicant
WELCOME!
The volunteer Fire-Rescue-Emergency Medical Service has a long and proud tradition of service in Maryland and the United States. For well over 200 years citizens have banded together to protect each other's property and lives in community based volunteer activity. Today the Fire-Rescue-EMS demands much in technical training and commitment of time. You need to have a basic understanding of what we are looking for in a volunteer today.
We are looking for volunteers who will have a responsible and mature attitude toward the duties that are assigned. As you progress in the volunteer fire service you will learn why we have Standard Operating Procedures. We need volunteers who can follow directions and not freelance; who are willing to work as a team under often difficult and stressful circumstances. We will train you to safely do things that you may have never thought you could do. You will see and experience things with which most people would never be involved. You will have the opportunity to make a positive difference in someone's life. You will develop a well deserved pride in your abilities and in this department. This is a volunteer activity. Your only reward is that of knowing you did the job that needed to be done when it had to be done. You will find the rewards of membership and active participation in the Upper Montgomery Volunteer Fire Department are those that mere money can never match.
(4) INFORMATION FOR THE APPLICANT
Membership in the Upper Montgomery Volunteer Fire Department requires a special commitment by you. In the first year you are expected to complete both Essentials for Firefighting and Emergency Medical Technician (Basic) classes taught at the Montgomery County Public Services Training Academy (PTSA) in Gaithersburg. In addition to these classes, Montgomery County requires that you complete several short classes on subjects such as protective gear, EEO and the Law, and Basic Hazardous Materials.
We are asking a lot of you that first year. In the future you will have the opportunity to take classes in Pumps, Truck Operations, Firefighter III, Hazardous Materials, Emergency Vehicle Operations, Practical Rescue, Emergency Medical Technician (Paramedic), Officership and Command, as well as others. All of these classes are offered at no cost to you. You will be issued, again at no cost to you, protective turnout gear and work uniforms. Your participation will be required in drills, membership meetings, and other department functions.
Yes, we ask a lot of you. In return for your time and effort you will be on the receiving end of one of the most rewarding jobs that one can have. You will make a positive difference in the lives of people that you know. The immense satisfaction that comes with active membership and participation in the UMCVFD will be something that will be with you forever. We are not looking for supermen and superwomen. We are looking for citizens who wish to learn and serve their community in a very special way… to make the Upper County a better and safer place in which to live, work, and grow.
(5) DUTIES THAT YOU WILL BE REQUIRED TO PERFORM
1) Attend the monthly meeting the first Tuesday evening of each month.
2) Attend two training drills a month. These are held on the third and fourth Tuesday evening of each month.
3) Respond to the station on as many calls as possible and remain at the station until the apparatus is placed back in service.
4) Take the required courses at the PSTA.
5) Assist with Departmental activities; i.e. fund raising dinners and breakfasts, putting up Christmas lights, etc.
YOU WILL BE TAUGHT THE FOLLOWING
1) How to safely respond to an emergency call.
2) The location of equipment on the different pieces of apparatus.
3) Apparatus running order and positions.
4) Safety on the job.
5) Care and use of your protective gear.
6) Care and use of SCBA (Self contained breathing apparatus).
7) Hose and ladder usage.
8) Department policies and procedures.
9) Communications, streets, and running routes.
10) The various officers; their responsibilities, and your duties.
(6) MEMBERSHIP REQUIREMENTS FOR THE ACTIVE FIRE/RESCUE/EMS GROUP OF THE
UPPER MONTGOMERY COUNTY VOLUNTEER FIRE DEPARTMENT, INC.
1) Junior Membership:
a) 16 years old
b) current enrollment in high school with passing grades
2) Cadet:
a) 16 years old
b) current enrollment in the Montgomery County High School Cadet Program
3) Regular Membership:
a) 18 years old
b) completion of high school or GED
Membership requires a Montgomery County administered physical examination and police background check including fingerprinting.
I have read and understand the membership requirements of the Upper Montgomery Volunteer Fire Department, Inc.
Name: ___________________________________
(Print)
Name: ___________________________________ Date: _______________
(Signature)
Parent/Guardian signature required for Junior and Cadet Status.
Name: _______________________________
(Print)
__________________________
(Signature)
(7)MEMBERSHIP APPLICATION
CATEGORY: Junior _______ Cadet __________
Regular _______ Fire/Rescue/EMS ______ EMS ______
Name: _____________________________________________________________
Address:____________________________________________________________
City: ___________________________ State: ___________ Zip: _____________
Phone: (Home) ________________________ (Work) _______________________
Birth date: ______________________ Social Security # _____________________
Emergency Contact: __________________________ Relationship: ____________
Phone: (home)________________________ (work) _________________________
E-mail address: _____________________________________________________________
Personal Physician: _____________________________ Phone #_______________
Drivers License: State ____ Class ____ Number ____________________________
Has your driver's license ever been suspended or revoked in any state? No___ Yes ___
Have you ever been convicted of any crime other than a traffic citation? No___ Yes ___
If so, the nature of crime: __________________________________________________
Previous experience or certification in Fire/Rescue or EMS:
(8)REFERENCES
Please list four people over the age of 21 who have personal knowledge of you. References may not be related to you by blood or marriage. Please provide name, address and phone number.
1) Name: ________________________________ Phone # ____________________
Address:___________________________________________________________
2) Name: ________________________________ Phone # ____________________
Address: __________________________________________________________
3) Name: _________________________________ Phone # ___________________
Address: __________________________________________________________
4) Name: _________________________________ Phone # ___________________
Address: __________________________________________________________
I certify that all the information that I have provided in this application is correct to the best
of my knowledge.
Name: ___________________________________________
(Print)
Name: ___________________________________________ Date: ________________
(Signature)
(9)DEPARTMENTAL ACTION
Sign Off Sheet
Date application received: _________________________________________________
Received by: ____________________________________________________________
Approval of Membership Committee:
Date: ________________________________
By: _________________________________
(Signature)
Application Approved by Membership for Probationary Status:
Date: _______________________________
By: _______________________________
(Signature)
Granted Full Membership:
Date: _________________________________________
By: _________________________________________
(Signature)
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