Big Tree VFC – New Member Information

New Member Form

Name (First and Last Name) *

Address *

Address

City

State/Province

Zip/Postal

Date of Birth *

Cell Phone *

Cell Phone Carrier (AT&T, Verizon, Etc...) *

Email *

Facebook Account Name *

None

Type in NameType in Name

Emergency Contact (First and Last Name) *

Emergency Contact Phone Number *

Allergies *

None / Unknown

Yes, Indicate what type / detailsYes, Indicate what type / details

Religion *

None / Prefer To Not Answer

Write in AffiliationWrite in Affiliation

Blood Type *

Unknown

Write in Blood TypeWrite in Blood Type

EMS Level of Care *

Never had EMS License

Current EMS License (Provider level and number)Current EMS License (Provider level and number)

Hazmat Cert. Level *

None

Yes, Provide LevelYes, Provide Level

Fire Police Training *

Yes

No

AVET Training *

Yes

No

Rescue Training Other (If None type "None") *

Please attach a headshot of yourself for placement on your ID *

Maximum file size: 2.1MB

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No information, photos, files, or other material found on this website may be copied or used without the express written permission of the Big Tree Volunteer Fire Company

Contact Information
4112 Big Tree Road
Hamburg, NY 14075
Phone: 716-824-0264

In the event of an emergency please call 911

BIG TREE VOLUNTEER FIRE COMPANY

Big Tree VFC – New Member Information

New Member Form