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Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

You must be a Deer Park resident to join the Deer Park Volunteer Fire Department

Home Phone(Required)

Cell Phone(Required)

Email(Required)

Are you at least 18 years of age(Required)

You must be at least 18 years of age to join the Deer Park Volunteer Fire Department.

Do you hold a valid New York State Driver's License(Required)

You must hold a valid New York State Driver's License, Learners Permit or State ID. No substitutions.

Areas of Interest

Firefighter

Emergency Medical Technician

Both

Do you have Friends/Family already in the Fire Service in Suffolk County? (if so list names & department)

Questions/Comments