HERBERTSVILLE FIRST AID SQUAD INC.

375 Herbertsville Rd.

Brick, NJ 08724

Member; NJFAC                                    732-840-9116                        Fax 732-840-3008

APPLICATION FOR MEMBERSHIP

I,                                                     , DO HEREBY APPLY FOR                                                 MEMBERSHIP IN HERBERTSVILLE FIRST AID SQUAD. IF ACCEPTED, I AGREE THAT UPON INDUCTION INTO MEMBERSHIP I SHALL FAITHFULLY TAKE THE FOLLOWING OATH.

I,                                                     , DO SOLEMNLY SWEAR THAT I SHALL LIVE UP TO THE IDEALS AND TRADITIONS OF THE HERBERTSVILLE FIRST AID SQUAD. I AGREE TO RESPOND TO EMERGENCY AND FIRE CALLS WHENEVER POSSIBLE AND TO ATTEND MEETINGS AND DRILLS REGULARLY. I AGREE TO REFRAIN FROM DISCUSSION WITH NON-MEMBERS INTIMATE DETAILS CONNECTED WITH THE WORK OF THE SQUAD. I AGREE TO EXPECT NO FINANCIAL COMPENSATION FOR ANYTHING DONE TOWARDS CARRYING OUT THE PURPOSE OF THE SQUAD AS OUTLINED IN THE CONSTITUTION. I AGREE THAT UPON RESIGNING OR RETIRING MEMBERSHIP IN THE SQUAD I WILL RETURN ANY INSIGNIA, EQUIPMENT AND UNIFORMS BELONGING EITHER TO THE SQUAD OR FIRST AID COUNCIL.

DATE:                                                                                                                                        

                                                                                           SIGNATURE OF APPLICANT

INTERVIEWING COMMITTEE SIGNATURES;          DATE INTERVIEWED;                   

1                                                    2                                                    3