ABBOTSFORD EMERGENCY SUPPORT SERVICES(ESS) VOLUNTEER APPLICATION

Thank you for your interest in the ESS volunteer position with the City of Abbotsford Emergency Program.

  • Please have all of your reference documents ready; read each question carefully and answer all required. If the question is not applicable, then type n/a in the answer box.
  • Upload file(s) in PDF or JPG format only; Maximum file size allowable is 1 GB.
  • THIS FORM MUST BE COMPLETED AND SUBMITTED IN ONE SITTING (CAN NOT BE SAVED AS A DRAFT).
  • * indicates required field

Once you have completed and submitted this application, a copy will be sent to an email address. Please DO NOT reply to this email.

For questions or inquiries contact Abbotsford Emergency Program at epo@abbotsford.ca

PERSONAL INFORMATION

* Last Name
* First Name
* Title
  • Mr
  • Mrs
  • Miss
  • Ms
* Street Address
* City
* Province
* Postal Code
Mailing Address (If different)
Home Telephone Number
- -
* Cellular Telephone Number
- -
* Email

ADDITIONAL INFORMATION

* Date of Birth?
/ /
* Do you have valid Driver's License?
  • Yes
  • No
* Do you have Personal Transportation?
  • Yes
  • No
* Are you fluent (speak, read & write) in English?
  • Yes
  • No
* Are you fluent in any other languages?
  • Yes
  • No
* Are you willing to provide translation service?
  • Yes
  • No
* Are you able to provide a Criminal Record check and Vulnerable Sector Search from the local Police Department showing no criminal record exists or is pending?
  • Yes
  • No
* Are you an active member of the following Agencies?
  • ESS Team
  • Canadian Red Cross
  • St. John Ambulance
  • The Salvation Army
  • Other
  • N/A
* Are you currently employed?
  • Yes
  • No

EMERGENCY CONTACT

* First Name
* Last Name
* Relationship
* Address
* Phone Number
- -
* Cell Phone Number
- -
Email

OUT OF AREA CONTACT

In the event of a disaster in the Lower Mainland, it will be very difficult to make telephone calls using either landline or cell phones. As long distance calling lines will be more available than local calling lines, you should choose someone (preferably out of province or east of Kamloops) to act as an information link, so that family members can call and check in, both providing to and receiving information from your contact.

* First Name
* Last Name
* City, Province, Country
* Phone Number
- -
* Cell Phone Number
- -
Email

MEDICAL INFORMATION

* Do you have any serious medical restrictions that may affect your ability to perform the job duties of an ESS volunteer?
  • Yes
  • No
* Do you have any life threatening allergies?
  • Yes
  • No
* Do you wear a Medic Alert Tag?
  • Yes
  • No
* Do you carry medication with you at all times?
  • Yes
  • No
* Do you have any physical limitations (ie. heavy lifting) that may affect your ability to perform the job duties of an ESS volunteer?
  • Yes
  • No

VOLUNTEER EXPERIENCE

List any previous ESS training or emergency/disaster related experience:
Volunteer Experience (ie Search and Rescue, Red Cross)

PROFESSIONAL REFERENCES

Please provide three professional references. (employer, a colleague, or a supervisor, but no friends or relatives)

* Full Name (First, Last)
* How do you know this person?
* For how long have you known this person?
* Phone Number
- -
Email
* Full Name (First, Last)
* How do you know this person?
* For how long have you known this person?
* Phone Number
- -
Email
* Full Name (First, Last)
* How do you know this person?
* For how long have you known this person?
* Phone Number
- -
Email

APPLICANT'S DECLARATION

* I understand that I am required to be available day or night for callouts. Including one week rotations on a pager.
  • Yes
* I understand that I am to attend all ESS required training sessions.
  • Yes
* I also understand that an appointment to any position is dependent upon successful completion of a Police Information Check and Vulnerable Sector Search

  • Yes
* I understand that any equipment, uniforms, protective clothing, training materials, identification cards or badges, or any other item which may be provided for my use, is the property of City of Abbotsford Fire Rescue Service - Emergency Program and must be promptly returned to the ESS Program coordinator upon my leaving the program, whether by resignation, dismissal or any other means.
  • Yes
* I acknowledge that department rules, guidelines, policies and procedures may establish requirements for specific levels of attendance at department activities.
  • Yes
* I understand that participation in department activities may make me privy to information about citizens of the fire protection area, members of the department, department activities or other information of a personal or confidential nature and I will not reveal or discuss that information, except as required to carry out my duties as an ESS Volunteer.
  • Yes
* How did you hear about the Abbotsford Emergency Program ESS Volunteer Program?
  • Civic Info
  • Electronic sign ad
  • Friend/ City employee
  • Newspaper ad
  • Website
  • Other

Important: Please ensure all required documents are uploaded as part of the application process. Incomplete application will not move forward in the recruit process.

* I hereby certify that the information given on this application is true and I understand that any untrue statements may be grounds for dismissal or revocation of application.
  • Yes
* I agree that by clicking on the "Submit" button of this application I am effectively signing my application.
  • I Agree