About Us

Application Area

It is only through volunteers such as yourself that we as a community can be prepared for any emergency that may
arise. Volunteers are utilized in the following areas; Search, Evacuation, Rescue, Advanced First Aide, Extrication, Fire
Safety Techniques, Electrical Safety, Water Rescue, and a wide variety of other training areas in conjunction with
Emergency Services.

Volunteer Application

Contact Information

First Name

Phone Number

Last Name

Mobile

Home

Work

City of
Residence

E-Mail

Residence
Zip Code

Training, Certifications, and Experience

Medical Training

CPR

Basic First Aide

Adv. First Aide

EMT Level 1

EMT Level 2

Paramedic

LVN

Emergency Services Training and Experience

Search & Rescue

Light Extrication

Heavy Extrication

Water Safety/Rescue

Electrical Safety

EOD

Instructor Experience or Certification

EMS/ESS Instructor

Medical Instructor

Other Instructor

Days & Hours Available to Volunteer

Weekdays

Week Nights

Weekend Nights

Weekend Days

Any

Criminal Record

Disclaimer Notice: A criminal Record does not mean that you would not be able to volunteer. It is the nature of the
crime itself, regarding theft or a violent act that may preclude us from utilizing you in a volunteer capacity.

Infraction

Misdemeanor

Felony

Year

Offense Charged

Offense Convicted of

Explanation of Criminal Offense

Personal Information

Drivers License
Number

State of
Issuance

Social Security
Number

Disclaimer Notice: A Background check will be conducted for each volunteer with regards to Criminal History only. The information collected will
not be used for any other purpose than to confirm whether the volunteer member has been truthful regarding their criminal background. By
submitting this application you have read, understood, and agreed to allow SDV authenticate your criminal history. All results will be kept
confidential and will not be distributed to any person or outside agency not affiliated with SDV.

Tell Us About Yourself & Your Desire to Serve Your Community
(Optional)

Those Who Can Serve.....Should Serve!!!

SAN DIEGO VOLUNTEERS