Online Application

Please fill out the form below and a member of our company will get back to you.
Thank you for your interest with Station 247.

Online Application

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Classification of membership categories and definitions

Active

This classification of membership will be used for members using Berkeley Hills Fire as their primary Fire Company. All membership requirements are applicable and must be followed to maintain “active” status i.e our internal points system to be discussed in the membership interview. .These members will be expected to perform firefighting and/or medical duties up to their level of training completed in accordance with BHFC policies and procedures.

Special Active

This membership classification is designed for members who already have a “Home” department looking for additional training and or experience. Special active members must already be trained in the minimum standard of firefighter training (FF1) and must currently be employed or volunteer with another fire department. The only exception to this rule would be if the individual seeking membership has 20 years or greater of firefighting experience in either career or volunteer departments (May combine time if applicable)

Junior Active

This membership classification is for members between the ages of 16 and 18 looking to start in firefighting and or ems training. All applicable work permits and state child labor laws must be adhered to along with a parental signature of understanding of the role.

Administrative

This membership classification does not perform firefighting or ems duties. These members are responsible for administrative duties and or participation of events for the fire department i.e. fundraising, public relation events etc

QRS

This membership classification is for trained EMTs, AEMTs and Paramedics seeking a medical only role performing skills up to their level of medical training. Minimum requirements for this position include a valid in date CPR card as well as a valid in date medical license (EMT, AEMT, Paramedic) This classification does not perform firefighting duties.

I am interested in*

Must choose only one

Active

Special Active

Junior Active

Administrative

QRS

Have you lived in Pennsylvania for the last 10 years?*

Yes

If you have lived in Pennsylvania for the last 10 years:

Complete a Pennsylvania Criminal History Background Check and a Pennsylvania Child Abuse Clearance (free if no other free checks done in last 5 years), or turn in copies of prior checks if within the past six months:

Criminal: https://epatch.state.pa.us/ Submit a New Record Check for volunteers.

Child Abuse: https://www.compass.state.pa.us/cwis/public/home Create a new account if you do not already have one. Create a new Clearance Application, selecting “Volunteer” and using “Berkeley Hills Fire Company” as the business name.

All relevant documents (Clearances, work permits, junior acknowledgements) should be scanned and sent to membership@station247.org

If you have lived outside of Pennsylvania within the past 10 years , complete the childline as well as an FBI Criminal History Record Clearance. There is a cost associated with this background check that may be reimbursed by the Company if your application is accepted.

FBI: https://uenroll.identogo.com/ Enter Service Code 1KG6ZJ, complete the pre-registration application, and follow the instructions to have your fingerprints taken.

All relevant documents (Clearances, work permits, junior acknowledgements) should be scanned and sent to membership@station247.org

Applicant Information

Full Legal Name*

Address*

Cell Number*

Cellphone Carrier*

Email*

Active Alert ID Number

(if already have an Active Alert ID Number, if not, skip)

Emergency Contact*

Emergency Contact Phone Number*

Emergency Contact Relationship to You*

Have you ever been convicted of a crime?*

Yes

If yes, please explain below*

List ALL Certifications (Both EMS and Fire) with ID numbers AND Expirations if applicable. Remember, Firefighting Proboard classes have ID numbers*

List your current and past Emergency Services Affiliations.*

Special Active must have at least one current affiliation.

Applicant Current Occupation:*

Employer:*

Supervisor Name*

Supervisor's Phone Number

References

Three References NOT including family members

Reference One Name*

Relationship to Applicant*

Contact Phone Number*

Reference Two Name*

Relationship to Applicant*

Contact Phone Number*

Reference Three Name*

Relationship to Applicant*

Contact Phone Number*

Dates/Times that applicant is available for membership “interview” and ride along*

Online Application

Please fill out the form below and a member of our company will get back to you. Thank you for your interest with Station 247.