Thank you for your interest

Please fill out the below application and an Officer will contact you.

Name *
Name
Address *
Address
Date of Birth *
Date of Birth
Phone *
Phone
Name of Emergency Contact *
Name of Emergency Contact
Phone Number of Emergency Contact
Phone Number of Emergency Contact
Do you have a current driver's license? *
Are you a member of or employed by an Emergency Service? (Fire / Police / EMS) *
Do you have any previous medical training? *
Please provide 3 references - two personal and one professional
Personal Reference #1 *
Personal Reference #1
Phone *
Phone
Have you ever been convicted of any crimes? Violations, Misdemeanors, Felonies, Traffic Summons?
BY SUBMITTING THIS APPLICATION THE APPLICANT AUTHORIZES THE DOBBS FERRY VOLUNTEER AMBULANCE CORPS, INC. TO VERIFY ALL INFORMATION SUBMITTED. VERIFICATION MAY INCLUDE A REVIEW OF ALL CRIMINAL AND MOTOR VEHICLE RECORDS. THE APPLICANT AGREES TO ABIDE BY THE DOBBS FERRY VOLUNTEER AMBULANCE CORPS, INC. BY-LAWS AND STANDARD OPERATING PROCEDURES ONCE BECOMING A MEMBER. FAILURE TO ABIDE BY THESE RULES MAY RESULT IN A DENIAL OF MEMBERSHIP OR EXPULSION. Submission of this application does not guarantee membership.