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Volunteer Now
Heather Locke
2023-05-19T19:10:19-04:00
Volunteer Interest Form
Name
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Email
Phone
Participating Departments You Are Interested In
Chinquapin Volunteer Fire & Rescue
East Bend Volunteer Fire Department
Elizabethtown Fire Department
Fall Creek Volunteer Fire Department
French Broad Volunteer Fire & Rescue
Gaston VFD (Northampton County)
Harnett County Chiefs Association
Hiwassee Dam Volunteer Fire Department
Lewisville Volunteer Fire Department
Rural Hall Fire Department
Silver Lake Volunteer Fire Department
Town of Winterville Fire Department
Wake County Fire Services
West Buncombe Volunteer Fire Department
Youngsville Volunteer Fire Department
Other
If you are interested in another department please select “Other”
Which county do you live in?
Alexander
Alleghany
Anson
Ashe
Avery
Beaufort
Bertie
Bladen
Brunswick
Buncombe
Burke
Cabarrus
Caldwell
Camden
Carteret
Caswell
Catawba
Chatham
Cherokee
Chowan
clay
Cleveland
Columbus
Craven
Cumberland
Currituck
Dare
Davidson
Davie
Duplin
Durham
Edgecombe
Forsyth
Franklin
Gaston
Gates
Graham
Granville
Greene
Guilford
Halifax
Harnett
Haywood
Henderson
Hertford
Hoke
Hyde
Iredell
Jackson
Johnston
Jones
Lee
Lenoir
Lincoln
Macon
Madison
Martin
McDowell
Mecklenburg
Mitchell
Montgomery
Moore
Nash
New Hanover
Northampton
Onslow
Orange
Pamlico
Pasquotank
Pender
Perquimans
Person
Pitt
Polk
Randolph
Richmond
Robeson
Rockingham
Rowan
Rutherford
Sampson
Scotland
Stanly
Stokes
Surry
Swain
Transylvania
Tyrrell
Union
Vance
Wake
Warren
Washington
Watauga
Wayne
Wilkes
Wilson
Yadkin
Yancey
Preferred Language
English
Spanish
Other
How did you learn about us?
Banner/Sign
Brochure/Flyer
Departmental reputation
EMS referral
Facebook
Family or friend referral
Fire station proximity to home
Fire station/ Open House
Firefighter referral
Fundraising event
Hotline Advertisement
I am a member in another department
I was a member previously
Newspaper
Poster
Radio
Recruitment night
School Visit
Television
Twitter
Valpak/Direct mail
Website/Internet search
Word of mouth
Other
Please describe how you learned about us.
Please let us know the event name and date.
What is your primary occupation?
Accommodations/Food service
Administrative Support
Agriculture
Arts/ Entertainment/Recreation
Construction
Educational services
Emergency medical service
Family care
Finance
Fire service
Health care
Information technology
Management
Military
Professional/Scientific
Public administration
Retail trade
Retired
Self-employed
Student
Transportation/Warehousing
Unemployed
Other
Please describe other primary occupation
What is your primary motivation for volunteering to be a firefigher?
Administrative duties
Adrenaline rush
Appreciation from people
Career experience
EMS response
Equipment (trucks, tools, etc.)
Family connection
Fire response
Friendship/Camaraderie
HAZMAT
Heightened community status
Incentives/Financial
Keeps me in shape
May be only thing I am good at
Personal fulfillment
Personal obligation
Receiving/Delivering training
Retirement benefits
Service to my community
Tax savings for the community
Other
Please describe other primary motivation
Demographic Information (Optional)
Ethnicity
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
Other
White
Gender
Male
Female
Non-binary
Agender
My gender is not listed
Prefer not to answer
Age
18-24
25-34
35-44
45-54
55-64
65+
Comments
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