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Public Safety Volunteer Application

  1. Making false statements on this application will automatically disqualify your application

    Please note: Office of EMS (OEMS) requires all applicants after July 1, 2013 to be fingerprinted for their background check

  2. Do you have a valid drivers license?*

  3. Have you ever been convicted of any law violation including a misdemeanor or felony?*

  4. Have you ever been convicted of any traffic violation?*

  5. Are you under the age of 18?*

  6. BY TYPING or SIGNING YOUR NAME, YOU ARE CERTIFYING THAT YOU HAVE READ AND AGREE WITH THE FOLLOWING STATEMENT IN ITS ENTIRETY.*

    I agree that my typed name on this document is the legally binding equivalent to my handwritten signature, and that the information provided is true and accurate to the best of my knowledge and is a complete record. I authorize the Department of Public Safety to investigate my criminal and motor vehicle operation background to verify the information is correct.

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  8. This field is not part of the form submission.