First Name*
Last Name*
Home Phone
Cell Phone (Required for IAM Responding Call Out App)*
Cell Phone Provider (e.g. Telus, Bell, Rogers)- Required for IAM Responding Call Out App*
Email* (Required for IAM Responding Call out App)

Mailing Address

Address Line 1
Address Line 2
City
Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukonNunavutNorthwest Territories
Postal Code
Country

Apex Mountain Physical Address (For Apex Part-Time or Full-Time Residents)

Address Line 1
Address Line 2
City
Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukonNunavutNorthwest Territories
Postal Code
Country

A wide range of skills are required to effectively operate a modern fire and rescue organization. Please provide the education and/or skill set(s) that you are willing to offer in supporting the operations of the Apex Fire Brigade Society

Please select all skills that apply, or provide additional skills in "other"

Animal Health TechAnimal RescueBuilding InspectionCarpenterChainsaw Operator/ FallerChemist/ Chemical EngineeringCoachingConstructionDisaster Response/ ManagementElectricianElectric UtilityFire AlarmsFire InspectionFire Sprinkler SystemsFirst AidForestry/ ForesterGas FitterGas/ Propane UtilityHazMatHeavy Equipment OperatorMechanic/ Vehicle RepairMillwrightNursingParamedic/ EMAPipefitterPlumberProfessional DriverPublic RelationsPsychology/ CounsellingRefrigeration SystemsSmall Engine RepairStructural Engineer/ Structural DesignStructural FirefighterSwiftwater RescueRope Rescue/ Rope Access/ Rock Climbing/ Alpine ClimbingTeacher/ InstructorUrban RescueVehicle ExtricationWildland Firefighter
Other Skill(s)

I would like to volunteer on the following committees (select all that you are interested in)

Outreach and Communications Committee: responsible for supporting both internal membership communications and external public communications and outreach under the direction of the AFBS board of directors

Fundraising Committee: responsible for implementing and coordinating a fundraising strategy, including seeking, and applying for grants under the direction of the AFBS board of directors

FireSmart Committee: responsible for the development of a community wildfire preparedness program under the joint direction of the AFBS board of Directors and with the support of the Apex Community Association board of directors

Emergency Planning Support Committee: responsible for supporting the development and implementation of various emergency response plans under the direction of the AFBS Board of Directors and with support of the Apex Community Association

I am applying to volunteer for the following emergency call-out support (non-firefighter) positions (select all that you are interested in):
Emergency Social Services: under the direction of the Fire Chief or designate, responsible for providing supply, service and social support to the public and residents who are affected or displaced as a result of an emergency incident

Fire and Emergency Operations Logistics Support: under the direction of the Fire Chief or designate, responsible for providing supply and service support during emergency response operations under the direction of the Fire Chief or designate

Fire and Emergency Operations Planning Support: responsible for providing planning support during emergency response operations under the direction of the Fire Chief or designate
None

Do you understand that you have the right to refuse any work or task that you perceive as unsafe, or you are not physically capable of safely performing while undertaking your duties as a volunteer AFBS member?*

YesNo

Are you willing to always make safety your first priority while undertaking the duties of a volunteer AFBS member?*

YesNo

Do you live full-time, year-round within the Apex village?*

YesNo- I reside part-timeNo- I do not have a residence at Apex

If you live part-time at Apex, how many days per year are you typically here?
If you live part-time at Apex,what months are your typically here?
Do you work at Apex Mountain Resort*

Are you 19 years of age or older?

YesNo

Are you willing and able to install the I Am Responding application on your mobile device and respond to emergencies 24 hours per day, 7 days a week, 365 days a year?

YesNo

Are you willing and able to participate in the occasional meeting or weekend training program?*

YesNo

Please place a check mark next to times that you are typically at Apex and available to respond to emergencies:

Are you willing to follow the Apex Volunteer Fire Rescue (AVFR) policies, training standards, directives, and standard operating guidelines?*

YesNo

If/when you are assisting with an emergency incident, or training exercise as a member of the AFBS , are you willing to follow the directions of your immediate supervisor in the Incident Command System structure?*

YesNo

Please read carefully:

I, the undersigned, apply to enroll as a volunteer recruit member of the Fire Department and, if accepted, undertake to perform such duties as may be assigned to me by the Board of Directors and/ or Fire Chief or delegated representative.

I understand that this is a volunteer position with no remuneration.

I understand the promotional opportunities will depend upon positions becoming available, the results of work performance, training evaluation, the recommendation of Fire Officers and approval of the Fire Chief.

I verify that the information contained on this application form is true and accurate.

I hereby give consent to the Apex Fire Brigade Society to conduct verification of the information given, as required.

I agree to the above