OCCUPATION: _______________________________________________ OCCUPATION ADDRESS: _______________________________________________ EMPLOYER: _______________________________________________ Page 1 of 8 ARE YOU AVAILABLE DURING Yes No YOUR NORMAL WORKING HOURS: (Please tick appropriate box) (See Clause 12 of Terms of Engagement of Retained Firefighter) DISTANCE FROM FIRE STATION TO: ___________ km/ Miles Residential Address: (Delete as appropriate) ___________ km/ Miles (Delete as appropriate) Occupational Address: Details of previous Fire Brigade ____________________________________ Service (if any): ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ Rank in Fire Service:
OCCUPATION: OCCUPATION ADDRESS: EMPLOYER: _______________________________________________ _______________________________________________ _______________________________________________ Page 1 of 8 ARE YOU AVAILABLE DURING YOUR NORMAL WORKING HOURS: (See Clause 12 of Terms of Engagement of Retained Firefighter) Yes No (Please tick appropriate box) DISTANCE FROM FIRE STATION TO: Residential Address: Occupational Address: ___________ km/ Miles (Delete as appropriate) ___________ km/ Miles (Delete as appropriate) Details of previous Fire Brigade Service (if any): Rank in Fire Service: ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________
Form,30742,en.docx