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Call-Volunteer Recruit Application 

This application is to be completed by the head of department or delegated authority. 

Please review the application instructions to ensure you have all applicable documents: Application Instructions

Application Instructions(Required)
This form can not be saved, application must be completed in its entirety. You will need pages 1 and 8 of the HRD Medical Form to continue.
Please indicate the full time or call-volunteer status of this applicant.
Recruit's Legal Name(Required)

Required Documents

Applications are not considered complete unless the valid copies of the below documents are received.
Date of Recruit's HRD Medical Examination(Required)
Must be within one year of class start date. Recruit is responsible for submitting up-to-date documentation prior to class start.
Preferred examples: Screen capture of email, PDF of email including the full passing result.
Drop files here or
Max. file size: 10 MB, Max. files: 1.
    Preferred examples: Screen capture of email, PDF of email including the full passing result.
    Drop files here or
    Max. file size: 10 MB, Max. files: 1.

      Application Information

      Leave blank if none available.
      This email will receive confirmation of submission.
      The number to contact during training hours (nights and weekends).
      If filling this out on behalf of your Department Chief, Please submit your email address for confirmation of submission.
      Department Mailing Address(Required)

      Availability

      Preferred Campus (Select all that apply)(Required)
      Preferred Start Date(Required)

      Attestations

      To be completed by the head of department or delegated authority.
      I hereby attest that I have the authority to sign this document on behalf of the department and to make the representations contained herein.
      Application Approval(Required)
      The completed application for the above-named recruit, a member of this department, is hereby submitted with my approval for enrollment in the Massachusetts Firefighting Academy. In consideration of the Academy permitting the above-named individual to utilize its facilities, or any facilities made available throughout the Commonwealth of Massachusetts, for the purpose of furthering their training and professional development in the Fire Service, I agree to hold harmless and indemnify the Massachusetts Firefighting Academy, the Department of Fire Services, the Executive Office of Public Safety and Security, the Commonwealth of Massachusetts, the owners or operators of any facilities made available, and all of their respective officers, employees, and agents from any and all liability, claims, or causes of action arising out of such use or participation in training activities, to the extent permitted by law.
      Full name of person filling out this form.

       

       

      Massachusetts Training Council Protective Clothing Compliance(Required)
      In accordance with the Massachusetts Fire Training Council policy for Live Fire Training Exercises and Evolutions, this
      section must be completed for each person who registers for any Academy program which includes live fire training.

      I hereby attest that the ensemble (ensemble includes helmet, protective hood, coat, trousers, gloves and boots) to be used by the above named Recruit will at all times throughout the participation of the live fire training, be less than ten (10) years old. In addition, I further attest that this ensemble also complies with the following standards:

      - NFPA 1971: Standard on Protective Ensemble for Structural Firefighting and Proximity Fire Fighting
      - OSHA 29 CFR 1910.156(e) (2) (iii)
      Full name of person filling out this form.

       

       

      Massachusetts Training Council Statement Of Compliance(Required)
      I have reviewed the Rules and Regulations for the Call-Volunteer Firefighter Training Program (dated February 2022), as established by the Massachusetts Fire Training Council. I have provided a copy of these rules and regulations to the above-named recruit and have reviewed their contents with them. I further acknowledge and agree that both the recruit and this department shall abide by all provisions set forth therein

      Furthermore, I certify that the recruit will be at least 18 years old at the start of the program, and that they have a High School Diploma or GED.
      Full name of person filling out this form.

       

       

      EMT / EMS Document (OPTIONAL)
      The above named applicant, a candidate for certification has received an evaluated program of instruction that fulfills the medical first responder training requirements of 105 CMR 171 as established by Massachusetts General Law chapter 111, section 201.

      Full name of person filling out this form.

       

       

      Massachusetts Training
      The above named applicant, a candidate for certification has received an evaluated program of instruction that fulfills the medical first responder training requirements of 105 CMR 171 as established by Massachusetts General Law chapter 111, section 201.

      Full name of person filling out this form.

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      Please click the "Submit" button below to complete your application.