Hampstead VFC Operational Fund
Upcoming Events
Nov 22, 2024
Town of Hampstead Tree Lighting
Dec 07, 2024
HVFC Holiday Bazaar
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2024 Responses
Fire
EMS
Jan
60
124
Feb
59
132
Mar
55
140
Apr
61
125
May
49
119
Jun
55
133
Jul
58
129
Aug
53
130
Sep
60
132
Oct
Nov
Dec
Total
510
1164
2023 Responses
Fire
EMS
Jan
58
155
Feb
49
149
Mar
54
131
Apr
61
124
May
49
133
Jun
81
136
Jul
69
141
Aug
71
110
Sep
49
114
Oct
55
130
Nov
67
131
Dec
54
145
Total
717
1599
Past Responses
Fire
EMS
2022
673
1500
2021
604
1440
2020
554
1143
2019
537
1208
2018
551
1390
2017
792
1454
2016
719
1397
2015
812
1410
2014
752
1288
2013
608
1251
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Oct 29, 2024
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Junior Membership Application
Indicates Required Field
Personal Information
Last Name:
First Name:
Middle Name:
Current Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Child's Email Address:
Parent's Email Address:
Parent #1 (or Guardian's) Name:
Parent #2 (or Guardian's) Name:
Emergency Contact Information
In Case of Emergency Contact #1:
Emergency Contact #1 Address:
Emergency Contact #1 City:
Emergency Contact #1 State:
Emergency Contact #1 Phone #:
Emergency Contact #1 Relationship:
Emergency Contact #2 Name:
Emergency Contact #2 Phone #:
Emergency Contact #2 Relationship:
References
Please provide the names of any fire company personnel you are acquainted with (if any):
Education ***Report cards are checked quarterly. The Junior must maintain at least a C average in school.***
Name of School Currently Enrolled:
Name of Counselor / Advisor:
Please upload a copy of your most recent report card:
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General Information (* Optional) NOTE: you must be ages 10 (enrolled in 5th grade) - 15 to apply.
Date of Birth:
Do you have any physical limitations or disabilities which may limit participation in physical activities?:
Select Below
Yes
No
If Yes, please describe:
Do you have any medical conditions we need to be aware of?:
Select Below
YES
NO
Please describe:
Why do you want to be a member of the Hampstead Junior Fire Company?:
NOTE: NO APPLICATION WILL BE ACCEPTED WITHOUT THE FIRST YEARS DUES PAID IN FULL!
In order to be considered for membership you must submit a recent photo with your completed application.:
Add files...
I certify that all statements are true. I understand that any false statements made will be grounds for rejection or dismissal. I agree to abide by the By-Laws and rules of the Hampstead Volunteer Company
By typing my name I am certifying that all the information is honest and correct.
Signature of Applicant:
Signature of Parent or Guardian (If applicant is under 18):
Date of submission:
10/29/2024 0708
Upon submission of this application you will be directed to our Square page so you may pay the $5.00 application fee.
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Hampstead Volunteer Fire Engine &
Hose Company No. 1
1341 North Main Street
P.O. Box 231
Hampstead, Maryland 21074
Emergency Dial 911
Station 2 Voice:
410-239-4280
Station 2 Activities:
410-374-2424
Station 2 Fax:
410-239-0523
E-mail:
info@hampsteadvfd.org
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