North Carolina Volunteer Workforce Solutions
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First Name
Last Name
Address
City
State
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AL
AK
AB
AZ
AR
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CA
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CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
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ME
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MD
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MT
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OR
PA
PE
QC
RI
SK
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
YT
Zip Code
Phone Number
Email Address
Participating Department You Are Interested In
Only the 14 participating departments are listed.
If you are interested in another department, please select "Other".
--Select--
Other
Brunswick County Fire Chiefs Association
Buncombe County Fire Chiefs Association
Chinquapin Volunteer Fire & Rescue
Cleveland County Firefighters Association
Forsyth County Fire and Rescue Association
Martin County Fire Association
McDowell Fire and Rescue Association
Pitt County Firefighter’s Association
Randolph County Association of Fire Chiefs
Ranlo Fire and Rescue
Silver Lake Volunteer Fire Department
Smith Grove Fire Department
Wayne County Firefighters Association
Yadkin County Fire & Rescue Association
Which county do you live in?
--Select--
Alamance
Alexander
Alleghany
AnsonÂ
Ashe
Avery
Beaufort
Bertie
Bladen
Brunswick
Buncombe
Burke
Cabarrus
Caldwell
Camden
Carteret
Caswell
Catawba
Chatham
Cherokee
Chowan
Clay
Cleveland
Columbus
Craven
Cumberland
Currituck
Dare
Davidson
Davie
Duplin
Durham
Edgecombe
Forsyth
Franklin
Gaston
Gates
Graham
Granville
Greene
Guilford
Halifax
Harnett
Haywood
Henderson
Hertford
Hoke
Hyde
Iredell
Jackson
Johnston
Jones
Lee
Lenoir
Lincoln
Macon
Madison
Martin
McDowell
Mecklenburg
Mitchell
Montgomery
Moore
Nash
New Hanover
Northampton
Onslow
Orange
Pamlico
Pasquotank
Pender
Perquimans
Person
Pitt
Polk
Randolph
Richmond
Robeson
Rockingham
Rowan
Rutherford
Sampson
Scotland
Stanly
Stokes
Surry
Swain
Transylvania
Tyrrell
Union
Vance
Wake
Warren
Washington
Watauga
Wayne
Wilkes
Wilson
Yadkin
Yancey
Preferred Language
--Select--
English
Spanish
Other
How Did You Learn About Us?
Banner/Sign
Brochure/Flyer
Departmental reputation
EMS referral
Facebook
Family or friend referral
Fire station proximity to home
Fire station/ Open House
Firefighter referral
Fundraising event
Hotline Advertisement
I am a member in another department
I was a member previously
Newspaper
Poster
Radio
Recruitment night
School Visit
Television
Twitter
Valpak/Direct mail
Website/Internet search
Word of mouth
Other
Learn About Us: Please describe other
If you learned about the opportunity to volunteer at an event, please specify the event (date and event name).
What is your primary occupation?
Accommodations/Food service
Administrative/Support
Agriculture
Arts/ Entertainment/Recreation
Construction
Educational services
Emergency medical service
Family care
Finance
Fire service
Health care
Information technology
Management
Military
Professional/Scientific
Public administration
Retail trade
Retired
Self-employed
Student
Transportation/Warehousing
Unemployed
Other
Occupation: Please describe other
What is your primary motivation for volunteering to be a firefighter?
Administrative duties
Adrenaline rush
Appreciation from people
Career experience
EMS response
Equipment (trucks, tools, etc.)
Family connection
Fire response
Friendship/Camaraderie
HAZMAT
Heightened community status
Incentives/Financial
Keeps me in shape
May be only thing I am good at
Personal fulfillment
Personal obligation
Receiving/Delivering training
Retirement benefits
Service to my community
Tax savings for the community
Other
Motivation: Please describe other
Demographic Information (optional)
Ethnicity
No response
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
Other
White
Gender
No response
Female
Male
Age
No response
18-24
25-34
35-44
45-54
55-64
65+
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