Close
Raffles
Water Rescue
Fire Prevention
Donation
Close
Home
About
History
Events
Hall Rental
Media
Gallery
Videos
Apparatus
Join Us
Members
Contact Us
Phone
610-287-9324
Close
Home
About
History
Events
Hall Rental
Media
Gallery
Videos
Apparatus
Join Us
Members
Raffles
Water Rescue
Fire Prevention
Donations
Contact Us
Join Us
Application For Membership
Personal & Contact Information
First Name
*
Middle Name
Last Name
*
Type of Membership
*
Select of Membership
Active Fire Member
Active Social Member
Active Fire Police Member
Active Fire (or Fire Police) and Social Member
Type of Membership
Date of Birth
Address
*
Address
Street Address 1
Street Address 1
Street Address 2
Street Address 2
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Home Phone
Cell Phone
Email
Driver Information
Drivers License #
State Issued
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Expiration
Have you ever been convicted of any offense other than a minor traffic violation?
*
No
Yes
If yes, please explain
Emergency Contact Information
Name of Emergency Contact
*
Relationship
*
Phone
Address of Emergency Contact
*
Address of Emergency Contact
Street Address 1
Street Address 1
Street Address 2
Street Address 2
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Employment Information
Current Employer
Current Employer Address
Current Employer Address
Street Address 1
Street Address 1
Street Address 2
Street Address 2
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Supervisor
Supervisor Phone #
Previous Membership & Experience
Do you have any physical impairment that may interfere with your performance with USVFC?
*
No
Yes
If yes please explain
Have you ever been a member of any Fire/Rescue company?
*
No
Yes
If yes give aprox. date.
Department name, phone number & chief's name
List any certifications (Fire & EMS) or write 'None' *Please send all certifications to membership@usvfc.org
*
List Two(2) persons not related to you for references
Reference Name
*
Phone
*
Address
Address
Street Address 1
Street Address 1
Street Address 2
Street Address 2
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Reference Name
*
Phone
*
Address
Address
Street Address 1
Street Address 1
Street Address 2
Street Address 2
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
PLEASE READ AND SIGN
Print Name
*
Date
*
Date
Submit Application!
If you are human, leave this field blank.
Δ
Upper Salford Volunteer Fire Company is a self-supporting, nonprofit organization with its finances derived from various affairs held from time to time.
Get in Touch
782 Old Skippack Rd, Salfordville, Pa 18958
610-287-9324
Emergency: 911
Account Links
Account
Store
Member Links
Member Login
Member Only
Officer Only
© 2026 Upper Salford Volunteer Fire Company. Hosted & Maintained By FireCompanies.com Inc.