{"id":2500,"date":"2023-12-06T02:15:03","date_gmt":"2023-12-06T02:15:03","guid":{"rendered":"https:\/\/wallfirstaid.com\/?page_id=2500"},"modified":"2024-03-07T14:21:10","modified_gmt":"2024-03-07T14:21:10","slug":"join-the-squad","status":"publish","type":"page","link":"https:\/\/wallfirstaid.com\/join-the-squad\/","title":{"rendered":"Join the Squad"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2500\" class=\"elementor elementor-2500\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-dcd90be elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"dcd90be\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9ddc4d5\" data-id=\"9ddc4d5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ad514dd elementor-widget elementor-widget-spacer\" data-id=\"ad514dd\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a00e54b elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a00e54b\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-extended\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-03e2d74\" data-id=\"03e2d74\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-96c32a1 divider_yes aleft elementor-invisible elementor-widget elementor-widget-wgl-info-box\" data-id=\"96c32a1\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"wgl-info-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"wgl-infobox-content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><\/div><div class=\"wgl-infobox_content\"><p><span><strong>Why join the Wall First Aid &amp; Rescue Squad?<\/strong> Because we need you and your community needs you. For some of our members, the WFA brings a sense of satisfaction of giving back to the Wall Township community and contributing to someone\u2019s quality of life. For others, it is a way to help others in their time of need. <\/span><\/p><p><span>Our members love the camaraderie of being on this team and a sense of making a difference in the community. And\u2026 the excellent, hands-on training is a life long skill!<\/span><\/p><p><span> Follow the Step by Step instructions in our Membership Application Checklist. <\/span><a href=\"\/wp-content\/uploads\/2023\/12\/Membership-Checklist.pdf\"><strong>Click here<\/strong><\/a><span>\u00a0to access the Checklist. The online application form follows below.<\/span><\/p><p><span>As a safeguard against computer glitches, applicants are encouraged to send an e-mail to <strong><a href=\"mailto:membership@wallfirstaid.com\">membership@wallfirstaid.com<\/a><\/strong> letting us know that you have submitted an application.<\/span><\/p><p><span>If you do not hear back regarding your online application, please e-mail to <strong><a href=\"mailto:webmaster@wallfirstaid.com\">webmaster@wallfirstaid.com<\/a><\/strong> to confirm that it was successfully delivered by the system.<\/span><\/p><\/div><\/div><\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-62ffc5c elementor-widget elementor-widget-spacer\" data-id=\"62ffc5c\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-8f4b6dc\" data-id=\"8f4b6dc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-881591a elementor-widget elementor-widget-wgl-image-layers\" data-id=\"881591a\" data-element_type=\"widget\" data-widget_type=\"wgl-image-layers.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"wgl-image-layers\"><div class=\"img-layer_image-wrapper fade_in\" style=\"z-index: 1\">\n                <div class=\"img-layer_item\" style=\"transform: translate(0%, 0%);\">\n                    <div class=\"img-layer_image\" style=\"transition: all 800ms; transition-delay: 600ms;\">\n                        <img decoding=\"async\" src=\"https:\/\/wallfirstaid.com\/wp-content\/uploads\/2023\/12\/WFA_Join_Training-2-e1709821153635.jpg\" alt=\"Wall First Aid Squad in Wall NJ Training Room\" \/>\n                    <\/div>\n                <\/div>\n            <\/div> <\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9eca558 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9eca558\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-extended\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f4eddef\" data-id=\"f4eddef\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap 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gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_7\" ><h3 class=\"gsection_title\">Application for Membership:<\/h3><\/div><div id=\"field_2_48\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_48\" >Federal and State laws prohibit discrimination in membership because of sex, age, race, color, religious creed, marital status, National origin, ancestry, height, weight, liability for service in the Armed Forces of the United States, or other non job-related handicap or disability.<\/div><div id=\"field_2_49\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full title-weight field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_49\" ><label class='gfield_label gform-field-label' for='input_2_49'>Date Application<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_49' id='input_2_49' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_49_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_49_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_49' class='gform_hidden' value='https:\/\/wallfirstaid.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_2_5\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full title-weight field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_5\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Type of Application:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_5'><div class='gchoice gchoice_2_5_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.1' type='checkbox'  value='Active\/Associate EMT'  id='choice_2_5_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_5_1' id='label_2_5_1' class='gform-field-label gform-field-label--type-inline'>Active\/Associate EMT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_5_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.2' type='checkbox'  value='Driver\/Transport'  id='choice_2_5_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_5_2' id='label_2_5_2' class='gform-field-label gform-field-label--type-inline'>Driver\/Transport<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_5_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.3' type='checkbox'  value='Non-EMT Community Member (Administrative and Other Support)'  id='choice_2_5_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_5_3' id='label_2_5_3' class='gform-field-label gform-field-label--type-inline'>Non-EMT Community Member (Administrative and Other Support)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_8\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_8\" ><h3 class=\"gsection_title\">Applicant:<\/h3><\/div><div id=\"field_2_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_9\" ><label class='gfield_label gform-field-label' for='input_2_9'>Name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_2_9' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_10\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_10\" ><label class='gfield_label gform-field-label' for='input_2_10'>Present Address Street:<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_2_10' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_11\" ><label class='gfield_label gform-field-label' for='input_2_11'>Present Address Town:<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_2_11' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_12\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_12\" ><label class='gfield_label gform-field-label' for='input_2_12'>Present Address Zip Code:<\/label><div class='ginput_container ginput_container_number'><input name='input_12' id='input_2_12' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_13\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_13\" ><label class='gfield_label gform-field-label' for='input_2_13'>Primary Phone:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_13' id='input_2_13' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_14\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-quarter field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_14\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Type:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_14'><div class='gchoice gchoice_2_14_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='Home'  id='choice_2_14_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_14_1' id='label_2_14_1' class='gform-field-label gform-field-label--type-inline'>Home<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_14_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.2' type='checkbox'  value='Cell'  id='choice_2_14_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_14_2' id='label_2_14_2' class='gform-field-label gform-field-label--type-inline'>Cell<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_16\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-quarter field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_16\" ><label class='gfield_label gform-field-label' for='input_2_16'>Alternate Phone:<\/label><div class='ginput_container ginput_container_phone'><input name='input_16' id='input_2_16' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-quarter field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_17\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Type:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_17'><div class='gchoice gchoice_2_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='Home'  id='choice_2_17_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_17_1' id='label_2_17_1' class='gform-field-label gform-field-label--type-inline'>Home<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_17_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.2' type='checkbox'  value='Cell'  id='choice_2_17_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_17_2' id='label_2_17_2' class='gform-field-label gform-field-label--type-inline'>Cell<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_18\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_18\" ><label class='gfield_label gform-field-label' for='input_2_18'>E-Mail Address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_18' id='input_2_18' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_2_19\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_19\" ><label class='gfield_label gform-field-label' for='input_2_19'>Date of Birth (DOB):<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_19' id='input_2_19' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_19_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_19_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_19' class='gform_hidden' value='https:\/\/wallfirstaid.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_2_20\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_20\" ><label class='gfield_label gform-field-label' for='input_2_20'>Age:<\/label><div class='ginput_container ginput_container_number'><input name='input_20' id='input_2_20' type='number' step='any'   value='' class='medium'    placeholder='Years'  aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_21\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_21\" ><h3 class=\"gsection_title\">Background:<\/h3><\/div><fieldset id=\"field_2_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_22\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Previous EMS Experience?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_22'><div class='gchoice gchoice_2_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Yes'  id='choice_2_22_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_22_1' id='label_2_22_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_22_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.2' type='checkbox'  value='No'  id='choice_2_22_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_22_2' id='label_2_22_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_23\" ><label class='gfield_label gform-field-label' for='input_2_23'>If previous EMS experience, Squad or Private Ambulance Service Name?<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_2_23' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_24\" ><label class='gfield_label gform-field-label' for='input_2_24'>If previous EMS experience, Years of Service?<\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_2_24' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_50\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_50\" ><label class='gfield_label gform-field-label' for='input_2_50'>What State is your Driver&#039;s License Issued form:<\/label><div class='ginput_container ginput_container_select'><select name='input_50' id='input_2_50' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select><\/div><\/div><fieldset id=\"field_2_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_26\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Has your driver&#039;s license ever been suspended?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_26'><div class='gchoice gchoice_2_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Yes'  id='choice_2_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_1' id='label_2_26_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='No'  id='choice_2_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_26_2' id='label_2_26_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_27\" ><label class='gfield_label gform-field-label' for='input_2_27'>If your driver&#039;s license was suspended, Reason for Suspension?<\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_2_27' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_2_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_28\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Have you ever been convicted of an indictable offense or felony crime?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_28'><div class='gchoice gchoice_2_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Yes'  id='choice_2_28_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_28_1' id='label_2_28_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_28_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.2' type='checkbox'  value='No'  id='choice_2_28_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_28_2' id='label_2_28_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_29\" ><label class='gfield_label gform-field-label' for='input_2_29'>If yes, please explain:<\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_2_29' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_30\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_30\" ><h3 class=\"gsection_title\">Attestations:<\/h3><\/div><fieldset id=\"field_2_31\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_31\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >As a squad member, I will actively support the squad with my due share of time in fund raising activities, obey all rules and regulations as stated in the By-laws, and protect the property of the squad at all times:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_31'><div class='gchoice gchoice_2_31_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.1' type='checkbox'  value='Agree'  id='choice_2_31_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_31_1' id='label_2_31_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_31_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.2' type='checkbox'  value='Decline'  id='choice_2_31_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_31_2' id='label_2_31_2' class='gform-field-label gform-field-label--type-inline'>Decline<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_32\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_32\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Upon leaving the squad, I will return all squad-owned property in my possession:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_32'><div class='gchoice gchoice_2_32_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.1' type='checkbox'  value='Agree'  id='choice_2_32_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_32_1' id='label_2_32_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_32_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.2' type='checkbox'  value='Decline'  id='choice_2_32_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_32_2' id='label_2_32_2' class='gform-field-label gform-field-label--type-inline'>Decline<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_33\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_33\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >In making application for membership in the Wall Township First Aid &amp; Rescue Squad, I agree to provide to the Wall Township Police Department and\/or the Wall Township First Aid &amp; Rescue Squad Membership Committee any and all information, documentary or otherwise, as may be required for consideration of my application:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_33'><div class='gchoice gchoice_2_33_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.1' type='checkbox'  value='Agree'  id='choice_2_33_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_1' id='label_2_33_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_33_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.2' type='checkbox'  value='Decline'  id='choice_2_33_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_2' id='label_2_33_2' class='gform-field-label gform-field-label--type-inline'>Decline<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_34\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_34\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Wall Township First Aid &amp; Rescue Squad reserves the right to reject or accept this application without giving reasons:<\/legend><div class='ginput_container ginput_container_consent'><input name='input_34.1' id='input_2_34_1' type='checkbox' value='1'    aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_34_1' >I understand and agree with this condition of application.<\/label><input type='hidden' name='input_34.2' value='I understand and agree with this condition of application.' class='gform_hidden' \/><input type='hidden' name='input_34.3' value='1' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_2_35\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_35\" ><h3 class=\"gsection_title\">Parent\/Guardian Approval:<\/h3><div class='gsection_description' id='gfield_description_2_35'>If the applicant is under the age of 18 years old, a parent or guardian approval is required.<\/div><\/div><div id=\"field_2_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_36\" ><label class='gfield_label gform-field-label' for='input_2_36'>Parent\/Guardian Name and Relationship:<\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_2_36' type='text' value='' class='medium'    placeholder='First Middle Last, Relationship'  aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_2_37\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_37\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian Statement: As this applicant\u2019s parent\/legal guardian, I have reviewed this application and attest to its accuracy. I hereby grant permission for the applicant to apply for membership in Wall Township First Aid &amp; Rescue Squad:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_2_37'><div class='gchoice gchoice_2_37_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_37.1' type='checkbox'  value='Yes'  id='choice_2_37_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_37_1' id='label_2_37_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_37_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_37.2' type='checkbox'  value='No'  id='choice_2_37_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_37_2' id='label_2_37_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_38\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_38\" ><h3 class=\"gsection_title\">Employment:<\/h3><\/div><div id=\"field_2_39\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_39\" ><label class='gfield_label gform-field-label' for='input_2_39'>Present Employer:<\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_2_39' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_41\" class=\"gfield gfield--type-phone gfield--input-type-phone field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_41\" ><label class='gfield_label gform-field-label' for='input_2_41'>Present Employer Phone Number:<\/label><div class='ginput_container ginput_container_phone'><input name='input_41' id='input_2_41' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_42\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_42\" ><label class='gfield_label gform-field-label' for='input_2_42'>Number of Years with Present Employer:<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_2_42' type='text' value='' class='medium'    placeholder='Years'  aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_43\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_43\" ><h3 class=\"gsection_title\">References:<\/h3><\/div><div id=\"field_2_44\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_above hidden_label gfield_visibility_visible\"  data-js-reload=\"field_2_44\" ><label class='gfield_label gform-field-label' for='input_2_44'>References:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_44' id='input_2_44' class='textarea medium'    placeholder='Name, Address, Phone'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_2_46\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label gfield_visibility_visible\"  data-js-reload=\"field_2_46\" ><label class='gfield_label gform-field-label' for='input_2_46'>References:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_46' id='input_2_46' class='textarea small'    placeholder='Name, Address, Phone'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_2_45\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label gfield_visibility_visible\"  data-js-reload=\"field_2_45\" ><label class='gfield_label gform-field-label' for='input_2_45'>References:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_45' id='input_2_45' class='textarea large'    placeholder='Name, Address, Phone'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_2_51\" class=\"gfield gfield--type-Signature gfield--input-type-Signature gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_51\" ><label class='gfield_label gform-field-label' for='input_2_51'>Digital Signature<\/label><div class=\"ginput_container\" id=\"signature_id_51\"><div class=\"digi_signature_class\"><canvas id=\"gfds_signature_51\" gfds_id=\"51\" name=\"input_51\" class=\"signature-pad\" width=\"600\" height=\"200\" pad_back_color=\"#ffffff\" pad_pen_color=\"#000000\" pad_pen_width=\"2\"><\/canvas><input id=\"clear\" name=\"clear_data\" class=\"clearButton\" type=\"button\" data-action=\"clear\" value=\"Clear\" style=\"display: flex;\"><input class=\"custom_signature Digital-Signature\" type=\"hidden\" name=\"input_51\" id=\"51\" value=\"\"><\/div><\/div><span  class=\"gfds-form-control-wrap_Digital-Signature\"><div class=\"gfds_notice\">*Please use your curser \/ mouse to sign your name in the Digital Signature box (do not type). This will confirm your intention to join the Wall First Aid Squad personally. Thank you.<\/div><\/span><\/div><div id=\"field_2_47\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_2_47\" ><h3 class=\"gsection_title\">Submit Application:<\/h3><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_2' class='gform_button button' value='SUBMIT'  onclick='if(window[\"gf_submitting_2\"]){return false;}  if( !jQuery(\"#gform_2\")[0].checkValidity || jQuery(\"#gform_2\")[0].checkValidity()){window[\"gf_submitting_2\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_2\"]){return false;} if( !jQuery(\"#gform_2\")[0].checkValidity || jQuery(\"#gform_2\")[0].checkValidity()){window[\"gf_submitting_2\"]=true;}  jQuery(\"#gform_2\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' 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