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Hackettstown First Aid and Rescue Squad
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Have you been accepted previously by a First Aid Squad? If so please provide details.
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Have you ever been convicted for violations of any law or ordinance? (including traffic violations)
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If so please describe.
Have you ever been convicted of a Felony?
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No
If so please describe.
Have you been bonded?
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Have you ever refused bond?
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Do you Drive?
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How long have you had your drivers license?
Any Accidents in the the last 3 years?
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Total Points against license?
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Current Employer, Name, Address, Phone Number
Years worked there?
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Years worked there?
EMT Certification?
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Card Number and Expiration date
CPR Certification?
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Expiration Date
When are you available for Squad Activities?
Name other organizations to which you belong? (Excluding religious and political)
List 2 References other than relatives. Name, address, and phone number
Consent for a background check?
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Drivers License Number
Name as it appears on license
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Date of BIrth
Gender
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Eye Color
Height
Weight
Restriction on License
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