Fire Academy Application

Contact Information:

Fire Department

5077 John Tyler Highway
Williamsburg, Va 23185

P: 757-220-0626
F: 757-220-9125

For Emergencies dial 911

Email:

Operations

Emergency Medical Services

Name:
Address:
Phone:
Birth Date:
Birth Place:
Have you ever been convicted of a felony?	Yes No If yes, please explain
Do you have any physical disabilities requiring special accommodations?	Yes No If yes, please explain:
Why do you wish to participate in the Citizens' Fire Academy?
Would you like to spend a night in a fire station during your ride-along experience? (This is not a requirement.)	Yes No
Please provide the names, addresses, and phone number of two character references.	Name: Address: Phone:
	Name: Address: Phone:
E-Mail (optional)

Applications may also be mailed or delivered to:

Butch Tomes
James City County Fire Department
5077 John Tyler Highway
Williamsburg, VA 23185