Volunteer Membership Applications

Looking to serve your community? Join the Centereach Fire Department.
Applicants must be at least 18 years old and reside within the Centereach Fire District.

Indicates Required Field

First Name:
Last Name:
Date of Birth:
Home Address:
Contact Information
Phone Number:
Email Address:
Prior Fire/EMS History
Relevant Experience (If None, Enter N/A):
Do You Currently Hold Any Relevant Certifications?:		None CPR/ First Aid EMT Certification Paramedic Certification Firefighter I/II
Interest
Membership Type:		Firefighter EMS Both