Membership Application

Walnut Street Fire Co. No. 4 Membership Application

Please complete this membership application form in order to be considered for membership at Walnut Street Fire Company No. 4 By sending this application you are verifying that all information provided is accurate and has not changed to the best of your knowledge. You are also giving us permission to process your application and to submit you for membership consideration.

Once we receive your completed application we will contact you via email or phone to explain the process and update you on the overall timelines for consideration. Meanwhile, if you have any questions or concerns please email us at

Download and Print the Release Form

You will also need to download and complete the Request for Release of Records form. Once it’s completed and signed you can either give it to your Fire Company No. 4 sponsor(s), or we can make arrangements with you on where you can drop it off.

Request for Release of Records

Application for Membership

Please complete the following information to submit an application for membership.

  • MM slash DD slash YYYY
  • Please provide your home address.
  • Please briefly describe your job tasks.
  • Fire Department Experience

    Fire department experience is not required to apply for membership.
  • Please briefly explain and provide date ranges.
  • Background Information

  • Name and location (city, state).
  • Name and location (city, state).
  • Name and location (city, state).
  • Type of military and where served (if applicable).
  • References

  • Walnut St. Fire Co. #4 Sponsors

  • Sponsor's Name
  • Second Sponsor's Name

Go to the Join Fire Company No. 4 Page.

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