Citizens Fire Academy

This form is for joining the waitlist for the upcoming Hampden Township Citizens Fire Academy. It will be held on November 13th and 17. Completing this form does not guarantee a spot in the Citizens Fire Academy. Spaces are limited and submissions are processed first come first serve basis.

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 ZIP / Postal Code

Date Of Birth(Required)

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Shirt Size(Required)

Boot Size(Required)

Prior Fire Service Experience(Required)

Where did you hear about the Citizens Fire Academy

Additional Information/Comments

Waitlist

If there are no more seats for the upcoming Citizens Fire Academy, would you like to be added to a waitlist?

As part of this process, I understand a background investigation and reference check will be conducted by HTVFC and the Hampden Township Police Department (HTPD), or their respective agents, which will include a review of public records, and any criminal history. I further certify that all information provided is accurate and correct.

Est. 1954

Citizens Fire Academy

Hampden Township Volunteer Fire Company

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