Superior Fire Protection

Newton Fire Department Preliminary Proposition for Membership Form

Thank you for your interest in joining the Newton Fire Department. In order to assess your eligibility for membership, please provide the following information as completely as possible. Once received, your membership proposal will be provided to the Newton Fire Department committee charged with investigating new members. You will then be contacted to schedule an in-person interview and advise of the next steps required to complete your application.

1Personal Info

2Eligibility for Membership

3Residency and Employment

4Previous Firefighting Experience

5Legal Consents

6References

7Certifications

Your Personal Information

Your Name(Required)

Prefix First Middle Last Suffix

Date of Birth(Required)

Individuals must be a minimum of 18 years of age upon their election to department membership. 17 year-olds may submit their application for membership, but a departmental vote for approval will be delayed until the such time the applicant turns 18.

Those between 14 and 17 years of age may apply for membership under the Newton Fire Department Junior Firefighter Program.

MM slash DD slash YYYY

Contact information

Your Email Address

Enter Email Confirm Email

Home Phone

Cell Phone

Cell Carrier

Best Time To Call You

When is the best time for us to reach you via telephone?

Eligibility for Membership

This section will help you to determine whether you are eligible for membership in the Newton Fire Department.

Driving information

Do you possess a valid New Jersey Driver's license?(Required)

A valid New Jersey driver's license is required for membership. Out-of-state licenses are not accepted.

Yes

No

Upload your driver's license

Please upload a copy or photo of your New Jersey driver's license. (.jpg, .gif, .png, .pdf., .doc, or .docx format, please)

Drop files here or

Max. file size: 512 MB.

New Jersey Driver's License Number(Required)

Are your motor vehicle driving privileges currently suspended or revoked in New Jersey or in any other state?(Required)

Yes

No

Previous applications

Have you ever applied for membership in this or another fire department and been denied?(Required)

Yes

No

Please list the department(s) which denied the applications and describe the circumstances and reasons for denial(s).(Required)

Sponsoring Member

The Newton Fire Department is a fraternal organization and applicants must be sponsored by an existing member in order to apply. Please enter the name of the sponsoring firefighter below.

Don't know any Newton Firefighters? Stop by the firehouse to meet us, or give us a call at (973) 383-4746 to arrange a time to meet. We're friendly and approachable, and always looking for opportunities to get to know our community. Many current firefighters got to know us and gained an application sponsor this way. You could be next!

Name of Sponsoring Newton Firefighter

Residency

Newton Fire Department membership is limited to the residents of the Town of Newton and contiguous municipalities, as well as those who work within the Town of Newton and able to fulfill their membership duties during the course of that employment.

Home Address(Required)

Please provide your street address (no P.O. boxes, please).

Street Address Address Line 2 City State ZIP Code

Current Employment Information

Name of Employer

Position / Title

Employer Address

Street address, no P.O. boxes, please. Address Line 2 City State ZIP Code

Length of Employment

How long have you been employed with this company? (months/years)

Previous firefighting experience

No experience is necessary to become a Newton Firefighter. We will provide all training, gear, and equipment needed at no cost to you. However, if you already possess any relevant training or certifications, please provide that information in this section.

Have you ever been a firefighter before?(Required)

Yes

No

Previous Fire Departments

Please describe your previous firefighting experience. Use the + icon on the right to add additional lines.

Agency

City and State

Dates/Periods of Service

Ranks/Positions Held

Have you ever been a member of the New Jersey Firefighters Relief Asssociation?(Required)

Yes

No

Please describe your previous firefighting training, certifications, or firefighting experience, if any.

Upload copies of previous certifications, training certificates, resumes, or other documents relevant to your previous firefighting experience.

Provide documents in .pdf format, please.

Drop files here or

Accepted file types: pdf, Max. file size: 512 MB.

Legal consent for background and eligibility investigation

Background check

Do you swear and affirm that you are of good moral character?(Required)

Yes

No

Have you ever been convicted of a crime, disorderly persons offense, or felony in New Jersey or in any other state involving moral turpitude?(Required)

Yes

No

Do you consent and agree to the Newton Fire Department, the Town of Newton, its insurance providers, or other necessary entities obtaining a certified copy of your driver's license information and driver's history from the New Jersey Motor Vehicle Commission and any other entity?(Required)

Yes

No

Do you consent and agree to the taking of your fingerprints for the purpose of conducting a criminal background check?(Required)

Yes

No

Medical ability and physical examination

Are you of sound mind and body, medically and physically capable of performing the duties of a firefighter?(Required)

Yes

No

Do you agree to undergo a physical examination by a licensed physician practicing in the State of New Jersey and provide this department with a signed physician's certification form (New Jersey State Firemen's Association Form 100-A)?(Required)

Yes

No

Character References

Please provide names and contact information for at least three references (non-related) who can attest to your good moral character and suitability to serve in a position of public trust. Use the + icon on the right to add additional lines.(Required)

Name

Phone

How known

Tell Us About Yourself(Required)

Certification

Do you swear and affirm that all of the information you have provided in this application is truthful, accurate, and complete to the best of your knowledge?(Required)

Yes

No

Signature

Comments

This field is for validation purposes and should be left unchanged.

DUTY ~ HONOR ~ BROTHERHOOD

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