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Peters Township Fire Department
Volunteer Firefighter Application
Thank you for your interest in becoming a Volunteer Firefighter with the Peters Township Fire Department! PTFD has an extensive history of providing exceptional emergency response to Peters Township and surrounding residents for over 80 years, and we congratulate you on taking your first step to join our team. Below is a brief overview of our application process:
- Complete and submit the Application for Membership and Physical Agility Test Waiver
- Receive a Physical Exam from MedExpress Peters Township:
  3840 Washington Road
  McMurray, PA 15317
  (724) 941-3273
Once the above documentation has been received, our committee that oversees new applications will follow the below process:
1. Background checks performed.
2. References will be contacted.
3. Pending results of above checks, a physical agility test will be scheduled with the applicant.
4. After the in-person interview, the committee will present its recommendation to the organization at the monthly business meeting (first Monday of each month). It is suggested that the applicant be present for the business meeting, as they will be sworn into probationary status at this meeting, pending a positive outcome of the vote.
The application process typically takes 2-4 weeks; however, we encourage all applicants to attend our weekly trainings on Monday evenings during this time period to meet our team.
If you have any questions through this process, please contact us at (724) 941-4176 or email us at fire@peterstownship.com.
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Application for Membership

First Name*
Last Name*
Age*
Date of Birth*
Date of Birth
Do You Have a Drivers License?*
1. Yes
2. No
Class*
Expiration Date*
Expiration Date
Address*
City*
State*
Zip Code*
Home Phone Number*
Cell Phone Number*
Email Address*
Marital Status
Spouse Name
IF AT ABOVE ADDRESS LESS THAN FIVE YEARS, LIST PREVIOUS ADDRESS
Address
City
State
Zip Code
EDUCATION
High School Graduated From
Further Education
EMPLOYMENT
Present or Most Recent Employer
Occupation
Phone Number
INDICATE PRESENT OR FORMER AFFILIATIONS WITH THIS OR OTHER FIRE DEPARTMENTS
Fire Dept. Name(s)
Years of Service
List Duties and/or Offices Held
HISTORY
Have you ever been arrested and/or convicted of a crime?*
1. Yes
2. No
If yes, explain:
Have you ever had a serious illness in the past five years?*
1. Yes
2. No
If yes, explain:
Have you ever received compensation for injuries?*
1. Yes
2. No
If yes, explain:
REFERENCES
1. Name*
Phone Number*
Address*
City*
State*
Zip Code*
2. Name
Phone Number
Address
City
State
Zip Code
3. Name
Phone Number
Address
City
State
Zip Code
PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
Name*
Phone Number*
BENEFICIARY
Name
Phone Number
Name
Phone Number
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Agreement

This application is true and complete to the best of my knowledge. You are hereby authorized to make any investigation of my personal history. I understand that if I am accepted to this organization, falsified statements on this application shall be sufficient cause for my dismissal.
Applicant Signature*
By typing your name above, you agree to the terms of this application.
Date*
Date
Pennsylvania State Police Criminal Record Check
I acknowledge that the Peters Township Volunteer Fire Department will perform a PA State Police background check using the information provided in this application.
Initial*
By typing your initials above, you agree to the terms of this application.
Date*
Date
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Physical Agility Test Waiver

Peters Township Fire Department
Volunteer Firefighter Application
Physical Agility Test Description
Each applicant will be required to perform 10 evolutions associated with firefighting. The applicant will be required to wear a NFPA approved turnout coat, gloves, and helmet. The applicant will also be required to wear SCBA (self-contained breathing apparatus) less face piece. ALL of these evolutions will be monitored by Fire Department personnel, and the applicant will be required to perform all of the evolutions in six (6) minutes and thirty (30) seconds to be considered for membership.
Evolution 1: Hose Drag
The applicant will begin at the start line, when the applicant gives "go ahead" timing for the test will start. Applicant will be required to drag one section of 2.5 inch hose 40 feet to wall and back. Hose must cross the start line, and proceed to evolution 2.
Evolution 2: Hose Carry
The applicant shall lift a 50 foot section of 2.5 inch hose and place on shoulder. The applicant will then climb the stairs to the 2nd landing, turn around and descend the stairs, lay the section of hose down onto the ground and proceed to evolution 3.
Evolution 3: Ladder Carry
The applicant will be required to carry a 14 foot roof ladder 300 feet up and down a 5% grade utilizing the the conventional firemen carry and proceed to evolution 4.
Evolution 4: Ladder Raise
The applicant will be required to raise a 14 foot ladder against the side of the structure, set to the proper climbing angle, and proceed to evolution 5.
Evolution 5: Ladder Climb
The applicant will be required to ascend a 24 foot extension ladder (previously raised by Fire Department personnel), touch the top rung, and descend same and proceed to evolution 6.
Evolution 6: Wall Scale
The applicant will be required to scale a 4.5 foot wall, you must go through the window and onto the platform. NO running jumps will be permitted. The applicant will then proceed to evolution 7.
Evolution 7: Equipment Shuttle
The applicant will shuttle four (4) pieces of equipment up and down the stairs. The applicant will start at the bottom of the steps and carry one (1) piece of equipment up to 2nd landing, one (1) piece of equipment up to top of stairs, one (1) piece of equipment down to 2nd landing, and one (1) piece of equipment down to bottom. The applicant will then proceed to evolution 8.
Evolution 8: Tire Hit
The applicant will strike a truck tire across a 16 foot table using a 12 pound maul. The maul is not to contact the table. If the maul contacts the table the tire will be moved back to the beginning of the table. The applicant will then proceed to evolution 9.
Evolution 9: Tunnel Crawl
The applicant will crawl through a 36 inch pipe that is 20 feet long. The applicant will then proceed to evolution 10.
Evolution 10: Dummy Drag
The applicant will be required to drag a 145 pound dummy 45 feet to the end of the line utilizing a conventional firemen drag (applicant's arms under the arms of the dummy, around the chest, walking backwards). The time will stop once the entire dummy has crossed the finish line.
If after reading this narrative of the agility test you have any questions concerning any evolution, ask the Fire Department representative for clarification.
Physical Agility Test Waiver
By typing my name below, I hereby release the Township of Peters, the Peters Township Fire Department from all liability in the event of injury or death for the express purpose of participating in the physical agility test for active firefighter membership.
Signature*
By typing your name above, you agree to the terms of this application.
Date*
Date

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Volunteer Firefighter Application

Steps

Overview

Peters Township Fire Department

Application for Membership

EDUCATION

EMPLOYMENT

INDICATE PRESENT OR FORMER AFFILIATIONS WITH THIS OR OTHER FIRE DEPARTMENTS

HISTORY

REFERENCES

PERSON TO BE NOTIFIED IN CASE OF EMERGENCY

BENEFICIARY

Agreement

Physical Agility Test Waiver

Peters Township Fire Department

Physical Agility Test Description

Evolution 1: Hose Drag

Evolution 2: Hose Carry

Evolution 3: Ladder Carry

Evolution 4: Ladder Raise

Evolution 5: Ladder Climb

Evolution 6: Wall Scale

Evolution 7: Equipment Shuttle

Evolution 8: Tire Hit

Evolution 9: Tunnel Crawl

Evolution 10: Dummy Drag

Physical Agility Test Waiver

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