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Attachment#6 <br /> INDIAN RIVER COUNTY <br /> DEPARTMENT OF EMERGENCY SERVICES <br /> APPLICATION FOR VOLUNTEER SERVICE <br /> DATE: DIVISION: RACES Volunteer <br /> NAME: CALL SIGN: <br /> ADDRESS: <br /> PHONE#: DATE OF BIRTH: <br /> HEIGHT: SEX: RACE: HAIR COLOR: <br /> EYE COLOR: SOCIAL SECURITY #: - - <br /> DRIVERS LICENSE #: WEIGHT: <br /> Have you ever been convicted of an offense against the law or forfeited collateral, or are <br /> you now under charges for any offense against the law? You may omit: (1) Traffic <br /> Violations for which you paid a fine of $100.00 or less; and (2) Any offense committed <br /> before your 21 st birthday which was finally adjudicated in a juvenile court or under a youth <br /> offender law <br /> YES NO <br /> This identification badge remains the property of Indian River County and may only be <br /> utilized for official and authorized purposes for the time period shown on the badge. The <br /> badge cannot be transferred, loaned, or possessed by any other person. <br /> I understand that I am personally responsible for the badge issued to me and agree to <br /> surrender the identification badge to the Director of Emergency Services or his/her <br /> designee upon demand, termination of my volunteer service, or upon expiration. <br /> SIGNATURE OF APPLICANT: <br /> APPROVED BY: <br /> Director of Emergency Services or Designee <br /> BADGE NUMBER: EXPIRATION DATE: <br /> Indian River County Comprehensive Emergency Management Plan Annex VII - Page 36 <br />