Apply For Membership Form

The Raphine Volunteer Fire Company is always looking for dedicated members of our community who are willing to lend a helping hand.  If your looking to run calls, help with fundraisers and events, clean the station or just to learn and advance in the company it is up to you.  It is also a great way to meet new friends in the community.  We offer Junior Membership for applicants 16 to 18 years of age, Senior Membership for applicants over 18 years of age, and Contributing Membership for people who just want to help out without running calls.  We approve our new members on the second Thursday of each month at our Business Meeting.  If you are interested, please fill out the application below and someone will contact you as soon as possible.  Thank You.

Application For Membership


Type of Membership:
Full Name:
Zip Code:
Telephone #:
Date of birth:
SSN (Background Check Use Only):
Phsyical location of residence.
Current Level of Training:
Have you ever been on a Fire Dept. before?:  Yes
If so, please list Name and Number of Fire Dept.:
List 3 references other than fire members or relatives:



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