STFPD11 Volunteer Application
Yellow Advisory

Ready to begin an exciting new adventure? Or maybe it’s the start of a new career? Whatever it may be, we welcome you to apply for one of our volunteer firefighter positions. If you are looking into becoming a career firefighter, this is definitely a place to begin! We are always looking for hard-working, highly motivated people to help serve the community. We also offer an Auxiliary program for those under the age of 18. If you prefer to fill out an application in person, you can come by either our central station on Pine Street Extension or our station on Highway 3081. Thank you for your interest in Fire District #11!

 

Important Numbers

 

Fire or Medical Emergency:

9-1-1 or (985) 863-3133

 

Pearl River Police:

9-1-1 or (985) 863-5711

Website

 

St. Tammany Sheriff:

9-1-1 or (985) 898-2338

Website

 

Louisiana State Police:

9-1-1 or (985) 893-6250

Cellular: *LSP (*577)

Website

 

Pearl River Town Hall:

(985) 863-5800

 

 

Application Type:

 

Firefighter (Ages 18+)

Auxiliary Firefighter (Ages <18)

SSN:

Date of Birth:

Last Name:

First Name:

Street Address: 

City:

State:

Zip Code:

Home Phone Number:

E-mail Address:

Cell Phone Number:

Driver’s License Number:

Driver’s License State:

Have you ever been convicted of, or plead guilty to a felony or misdemeanor?

  Yes          No

If yes, explain:

 

What is the highest level of education you have received?

 

Please check any firefighting or related certifications/training that you have received:

 

Firefighter I

Firefighter II

 

Hazardous Materials Awareness

Hazardous Materials Operations

Hazardous Materials Technician

First Responder

Emergency Med Tech—Basic

Emergency Med Tech—Intermediate

Emergency Med Tech—Paramedic

Fire Apparatus Driver/Operator

Aerial Apparatus Driver/Operator

Vehicle Extrication Technician

Fire Instructor

Fire Inspector

Other  

 

Would you be willing to submit to a background check and drug screening?

Yes          No

Emergency Contact Name:  

Emergency Contact Phone Number:  

Relationship to you:

Additional Comments: