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05/23/2026
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2026 Incidents
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Total	264

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Membership Application

All applicants for active membership must comply with the following requirements:

A. Must be 18 or older

B. Shall submit a membership application, with current doctor’s physical form furnished by the Monelison Volunteer Fire Department, a recent photograph of applicant and a current DMV report covering at least three (3) consecutive years prior to application.

C. Be a resident of the Monelison Volunteer Fire Department district. Any variances to this requirement will be handled on a case-by-case basis.

D. Have NO criminal record involving felonies, Class I or II Misdemeanors, nor Misdemeanors of moral turpitude. A background check is performed on all applicants.

E. Shall have a good driving record (any negative points will be evaluated) and be in possession of a valid Driver’s License.

F. Shall not belong to, or join any other Volunteer Fire Department(s) or Rescue Squad(s) in the Commonwealth of Virginia.

G. Submit to an interview by the Monelison Volunteer Fire Department membership committee.

H. Submit to an Alcohol and or Drug Test, which may be scheduled by the Corporation, or any Officer if deemed necessary.

Indicates Required Field


Personal Information

First Name:
Middle Name:
Last Name:
Street Address:
City:
State:
Zip Code:
Email Address:
Phone Number:
Date of Birth:

Employment Information

Employer Name:
Employer Address:
Employer City:
Employer State:
Employer Zip Code:
Job Title:
Supervisor Name:
Supervisor Phone Number:
Supervisor Email:

Education

High School:
Last Grade Completed:
Diploma:
College:
Years Completed:
Degree Earned:
List any fire, rescue, and/or emergency training, experience, and certifications you currently hold (specify Pro-Board, IFSAC, or National Registery):

General Information

Have you ever been a member of any Fire or Rescue agency?:
Have you ever been denied membership, asked to resign, or had disciplinary action from any agency?:
Do you have any physical defects or have you sustained any injuries that may affect your ability to perform Firefighting duties?:
Have you been treated for a physical illness in the past 5 years?:
Have you ever been treated for a mental illness?:
Do you take medication regularly?:
Have you ever been convicted of any crime or traffic offense? Include misdemeanors, traffic, and/or felonies:
If you answered "YES" to any of the above questions please provide further details:
Do you consent to a search of conviction information from your local, state, and national criminal history files?:
Do you have a valid drivers license?:
State of Issue:
License Number:
License Expiration Date:
Do you consent to the release and review of your Driver's Transcript or Record now and on a periodic basis during service for repeated or significant traffic violations?:
Occasionally, an application makes it difficult for an individual to adequately summarize his/her complete background. Please use this space to summarize any additional information you would like to include. Also include why you want to join.:
How did you hear about Monelison Fire Department?:

Emergency Contact Information

Name:
Relation:
Address:
Email Address (Emergency Contact):
Phone Number (Emergency Contact):
PLEASE READ BEFORE SUBMITTING APPLICATION I hereby certify that the, facts set forth in the above Volunteer Application are true and complete to the best of my knowledge, and I have not intentionally omitted any information. I further certify that there are no willful misreprensentations or falsifications of the above statements and answers to questions. If an investigation discloses such misrepresentations, omissions, and/or falsifications, my application could be rejected, and I could be disqualified from ever providing volunteer services with Amherst County emergency services agencies in the future. The volunteer department and/or representative therof are hereby authorized to make investigations of my personal, criminal, driving and employment history. I consent to the release of information concerning my capacity and fitness by employers, educational institutions, law enforcement agencies, and other indivduals and agencies duly accredited. I understand that nothing said or implied during the application process should be deemed to constitute the terms of a contract. Volunteer service with any Amherst County Volunteer Fire Department or Rescue company or oganization is at will and may be terminated at any time, with or without notice, and with our without cause.

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