We currently have two different types of memberships available:
Running Active Member- This member may become a driver or EMT/first medic. Training and uniforms are provided.
Auxillary Affiliate – An applicant who is currently a member of another EMS agency. This member may be a driver or medic and must be able to fulfill a minimum monthly requirement of 12 hours.
For more information on the privileges and responsibilities of these two memberships or to make arrangements to visit our base, please call 586-5723 and leave your name and number.
Full
Auxiliary
Name:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Occupation:
Employer:
Age:
Date of Birth:
Email Address
I hereby state that all of the above questions have been answered truthfully and without gross omission, and I authorize the East Rochester Volunteer Ambulance Corps to check any or all of the above information with the appropriate law enforcement agencies. I also understand that willful falsification or omission from this application will subject me to immediate rejection or dismissal from membership. I FURTHER UNDERSTAND THAT I MUST SUBMIT TO A PHYSICAL EXAMINATION AND FURNISH RESULTS OF THAT EXAMINATION TO THE EAST ROCHESTER VOLUNTEER AMBULANCE CORPS PRIOR TO COMPLETION OF "NEW MEMBER TRAINING". I also understand that I will be an APPRENTICE/INTERN Member for a minimum of six (6) months. I agree to abide by the Constitution, By-Laws, Station Rules and all other rules, regulations, and policies of the East Rochester Volunteer Ambulance Corps. I also understand that there is no appeal to denial of this application.
I agree the the above.
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