Busti Fire Department Auxiliary
Busti, New York

Application For Membership



Name: _________________________________________________________________


Address: _______________________________________________________________

         _______________________________________________________________

Relationship to Fire Dept. Member: __________________________________________


What is your reason for wanting to become a member or the Auxiliary?



Do you understand that you must attend at least 3 meetings a year and are willing
to put forth a reasonable amount of time and effort helping at fund raising events
and be available if called upon to work at bazaars and other fundraising events? 
We rely on our members for the support, which keeps our organization strong.  It 
is also required that you serve in a serving committee once a year.

Do you understand that if accepted you will be on probation for one (1) year?

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An initation fee of one (1.00) dollar must accompany this application.  Dues will 
be thirty-five cents (35) per month, Until the first October then you will pay four 
($4.00) dollars per year thereafter.  

Do you swear to abide by all the rules and regulations as set forth in the by-laws of
the Busti Fire Department Auxiliary.  And are 18 Years of age or older?
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Signed ____________________________________  Date _____/_____/__________