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Application For Membership

The basic information below containing * is required, additional or sensitive such as SSN information will be collected during the interview and review process. Please provide as much information as you can below. Note that experience is not required, but do include any relevant information on prior work or volunteer experience. i.e. fire/law/ems, office/clerical, mechanical, technical, and/or public service. If you have no prior work experience, include a brief description of why you would like to join and the desired outcome if known (i.e. wish to become an EMT, etc.)

Home Address:

Mailing Address:

Previous Fire or EMS Experience: Required
Previous EMS Qualificatons:
Previous Responder Experience:

Emergency Contact:

Thank you! We’ll be in touch.

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HEADQUARTERS

Station 14-1

9978 US Hwy 12

Randle, WA 98377

(360) 497-7745

©2024 Randle Fire & EMS

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