Junior Firefighter Program - Augusta Township

Junior Firefighter Registration Form

Your Personal Information

Applicant Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address City Province Postal Code

Current School:(Required)

Current Grade:(Required)

T-Shirt Size:(Required)

Dietary Restrictions(Required)

Additional Information

Why do you want to become a Junior Firefighter?(Required)

What interests you most about Firefighting?(Required)

This program runs on the following dates from 19:00–21:00: July 2, July 6, July 14, July 20, July 28, August 11, August 17, August 25, August 31.(Required)

Please indicate your availability for these sessions.

Available for all dates

More than half of the dates

Less than half of the dates

Date(Required)

Please type your name below to form your signature(Required)

Signature

Parent/Guardian Information(Required)

First Last

Phone(Required)

Email(Required)

Signature(Required)