Membership Application

Thank you for your interest in the Burlington Township Fire Department. The following steps have been established to assist you in the timely completion of your membership application. If you have any questions regarding the application process please contact the Fire District office at 609-239-5849. The Fire District office is open Monday to Friday, 9am to 5pm.

Upon satisfactory completion of your application and approved background check, you will be scheduled for a Consultation/Interview with the department. Consultations/Interviews are held on the third Wednesday of each month at 7pm. You will receive a letter to advise you as to the date of your Consultation/Interview. Upon completion of your Consultation/Interview, you will receive an authorization form to obtain a physical.

Upon receipt of an Authorization to Obtain a Physical form you must schedule an appointment with the fire department physician. Once we receive acknowledgement that you have completed and passed the physical you will be accepted into the department.

Note: Those applicants who are already certified as New Jersey State Firefighters and/or EMT’s are requested to provide a copy of all your training certifications to date. This includes any emergency service related training courses you have completed.

Name *

First 5 SSN # *

Phone *

Street Address *

City *

State *

ZIP *

Email *

Sex *

Drivers License # *

State Issued By *

Date of Birth *

Place of Birth *

Are You A U.S. Citizen? *YesNo

What Position Are You Volunteering For? *FirefighterFire PoliceJunior Firefighter (Age 16 - 18)Social/Contributing

Have You Ever Been Arrested, Indicted, Or Convicted Of A Crime? *YesNo

If Yes, Please Explain *

References

List three personal references who are not relatives.

Name *

Address *

Phone *

Name *

Address *

Phone *

Name *

Address *

Phone *

Have you ever been or are you currently a member of another Fire Department?

Name

Address

Phone

Name

Address

Phone

The information that I have provided is both truthful and accurate to the best of my knowledge. I understand that willfully providing inaccurate information may result in the rejection of my application.

Name/Signature *

Date *

Instant Verification Form - Background Check Authorization

I understand that, for THE PURPOSE OF EMPLOYMENT, inquiries are to be made of myself, which may include but not be limited to: CRIMINAL RECORDS, MOTOR VEHICLE RECORDS. I authorize without reservation, any party or agency contacted to furnish and transmit the obtained information to: Burlington Township Fire Department I hereby totally release said agencies and the above named company, their officers, directors, employees and agents, collectively and personally from any actions and liabilities resulting from transmission and utilization of the results and opinions thereof.

Date *

Position Applying For *FirefighterFire PoliceJunior Firefighter (Age 16 - 18)Social/Contributing

Name *

Date of Birth *

SS# (1st five #'s) *

Address *

Email Address *

Previous Address (Please list all for last 10 years)

Have you ever been charged with or convicted of or pled guilty or Nolo contendere to a crime other than a minor traffic offense, or are there any criminal charges now pending against you? *YesNo

If Yes, please explain *

Driver's License # *

Name/Signature *

Junior Firemen's Auxiliary

We, the parent(s) or legal guardian(s) of the minor who has applied for membership in the Junior Firemen's Auxilary of the Burlington Township Fire Department, hereby grant our permissions for our son/daughter to join the said Auxilary pursuant to 40A:14-95 of the State of New Jersey. We further acknowledge receipt of the Rules and Regulations governing said Junior Firemen's Auxiliary.

Station # *

Fire Company *

Name/Signature of Parent/Guardian *

Name/Signature of Parent/Guardian *

Date *

Submit

ESSENTIAL FIRE FIGHTING FUNCTIONS

The medical requirements in this standard were based on in depth consideration of essential fire fighting functions .These essential functions are what fire fighters are expected to perform at emergency incidents and are derived from the performance objectives stated in NFPA 1001, Standard for Fire Fighter Professional Qualifications.

Such essential functions are performed in and affected by the following environmental factors:

• Operate both as a member of a team and independently at incidents of uncertain duration.
• Spend extensive time outside exposed to the elements.
• Tolerate extreme fluctuations in temperature while performing duties. Must perform physically demanding work in hot (up to 400 F), humid (up to 100%) atmospheres while wearing equipment that significantly impairs body-cooling mechanisms.
• Experience frequent transition from hot to cold and from humid to dry atmospheres.
• Work in wet, icy or muddy areas.
• Perform a variety of tasks on slippery, hazardous surfaces such as on rooftops or from ladders.
  Work in areas where sustaining traumatic or thermal injuries is possible.
• Face exposure to carcinogenic dust such as asbestos, toxic substances such as hydrogen cyanide, acids, carbon monoxide, or organic solvents either through inhalation or skin contact.
• Face exposure to infectious agents such as hepatitis B or HIV.
• Wear personal protective equipment that weights approximately 50 pounds while performing fire fighting tasks.
• Perform physically demanding work while wearing positive pressure breathing equipment with 1.5 inches of water column resistance to exhalation at a flow of 40 liters per minute.
• Perform complex task during life-threatening emergencies.
• Work for long periods of time, requiring sustained physical activity and intense concentration.
• Face life or death decisions during emergency conditions.
• Be exposed to grotesque sights and smells associated with major trauma and burn victims.
• Make rapid transitions from rest to near maximal exertion without warm-up periods.
• Operate in environments of high noise, poor visibility, limited mobility, at heights and in enclosed or confined spaces.
• Use manual and power tools in the performance of duties.
• Rely on senses of sight, hearing, smell and tough to help determine the nature of the emergency, maintain personal safety and make critical decisions in a confused, chaotic and potentially life-threatening environment throughout the duration of the operations.

FIREFIGHTER

Unreels, lays out, operates and directs hose lines discharging water or other fire suppressing agents
Enters structures to locate and extinguish seat of fire. Climbs ladders carrying heavy hoses of portable extinguishers. Makes forced entries by prying open or breaking doors, windows, etc.

Makes forced entry into burning or damaged aircraft and ships to rescue passengers and crew and to extinguish the fire. Uses hand and power tools as necessary. Heavy physical exertion is required as well as speed and agility.

Ventilates burning structures by opening doors and windows, or other existing openings. Sometimes cuts new openings in roofs and walls.

Performs rescue operations including climbing ladders, forcible entry, moving obstructions and moving through hot, smoke filled structures to locate and assist or carry victims out of the danger areas.

Performs salvage and overhaul operations

Maintains equipment

Attends daily drill and/or training sessions

FIREFIGHTER (DRIVER/OPERATOR)

Must know all the duties of the fire fighter.

Drives and performs light maintenance on mobile fire fighting equipment. Must be able to drive safely; know the best routes, including alternates, to fire location, place truck in proper position to fight particular kinds of fires under varying conditions, know how to operate the equipment, such as pumps, turrets, etc., and process a knowledge of basic hydraulics to determine amount of pressure to pump accordingly to the number and size of lines being services and to take full advantage of the amount of water available.

Normally takes charge of the crew in the absence of a regularly assigned crew chief.

FIRE POLICE OFFICER

It shall be the duty of a member of fire police to perform his duties under the supervision of the fire officer in charge of the fire or fire drill, until the arrival of a duly authorized police officer, who shall assume responsibility for the supervision of the performance of traffic duties, preservation of evidence and all other law enforcement duties.

Protect property and contents – Prevent theft, looting and malicious action by others. This includes the protection of property removed from the burning structure, provisions to protect property after the fire has been extinguished. This also includes protection of the fire apparatus from damage and prevention of damage to private property.

Prevention of disorders – The outbreak of disorder is a constant danger when people are gathered closely together. Emotions run high and trouble that begins in a crown can travel rapidly. Fire Police must pay attention to any unstable people in a crowd.

Establish and maintain fire lines – To provide ample space for firefighters to do their job in an efficient and safe manner and to rope off or completely cut off an unsafe area.

Traffic Control and Detours – Perform such traffic duties as necessary from the fire station to and at the vicinity of the fire, fire drill or other emergency call, until the arrival of a duly authorized police officer or at any public event where fire police services may be requested to protect. Such duties may at times require the fire police officer to be subject to over a single period of time harsh weather conditions such as but not limited to snow, ice, wind, sleet or rain.

Authorizational Duties – All fire police officers must wear an authorized fire police badge on the left breast of the outermost garment while on duty. Provided, however nothing herein contained shall give the fire police or any of them the right to supersede a duly authorized police officer. If any person shall unreasonably refuse to obey the orders of the fire police, a fire police officer may arrest him and keep him under arrest until the fire is extinguished or the drill completed. If the offender is found guilty by a municipal court or Superior Court, he shall be sentenced to pay a fine not exceeding $200 and costs.