Application For Membership

Personal & Contact Information

Address *
Address
Street Address 1
Street Address 2
City
State/Province
Zip/Postal

Driver Information

Have you ever been convicted of any offense other than a minor traffic violation? *

Emergency Contact Information

Address of Emergency Contact *
Address of Emergency Contact
Street Address 1
Street Address 2
City
State/Province
Zip/Postal

Employment Information

Current Employer Address
Current Employer Address
Street Address 1
Street Address 2
City
State/Province
Zip/Postal

Previous Membership & Experience

Do you have any physical impairment that may interfere with your performance? *
Have you ever applied for membership before? *
Have you ever been a member of any Fire/Rescue company? *
Attach Certificates

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List Three (3) persons not related to you for references

Address
Address
Street Address 1
Street Address 2
City
State/Province
Zip/Postal
Address
Address
Street Address 1
Street Address 2
City
State/Province
Zip/Postal
Address
Address
Street Address 1
Street Address 2
City
State/Province
Zip/Postal

PLEASE READ AND SIGN

I herby authorize Lanoka Harbor Vol. Fire Company #1, and its membership committee to investigate the statements made of this application. I will abide by the rules, regulations & by-laws set forth by Lanoka Harbor Vol. Fire Company #1. 

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The Lanoka Volunteer Fire Company provides fire suppression and rescue services as well as fire prevention activities to the Lanoka Harbor section of Lacey Twp. We also provide mutual aid into our neighboring section of Forked River, as well as other municipalities within Ocean County.
Mailing Address
Lanoka Harbor Vol. Fire Company #1
PO Box 8
Lanoka Harbor, NJ 08734

Physical Address

Lanoka Harbor Vol. Fire Company #1
2 Warren Ave
Lanoka Harbor, NJ 08734
Phone & mail
  • 1-609-693-4998
  • Lanokaharborfd@gmail.com
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