"I hereby certify that the information contained in this application form, is true and correct to the best of my knowledge. I fully understand that any falsifications on said application would be grounds for the disqualification of the applicant. I hereby authorize the Bethel Park Volunteer Fire Company to have a criminal history, driving record, child abuse history and personal reference checks performed by an independent investigator, an investigation by the Bethel Park Police Department and/or any authorized member of the Bethel Park Volunteer Fire Company. The criminal history and child abuse check may include a local and national police check.

I understand that if my application is accepted by the Bethel Park Volunteer Fire Company that I will be on Fire Company probation for a period of at least twenty four (24) months. After twelve months (12) of my probationary period the Fire Department Membership may may terminate my membership for any reason deemed valid according to our by-laws.

All qualified applicants will be considered without regard to race, color, religion, national origins, ancestry, sex, disabilities or age (40 and over). All information requested on this application form is solicited for the purpose of determining abilities and skills required for membership into the Bethel Park Volunteer Fire Company and to facilitate verification for the information requested.

I hereby acknowledge that I have read this section of the membership application and fully understand the meaning and effect of signing this form.