Mechanicsville Volunteer Rescue Squad, Inc.
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2023 Incidents
January 261
February 258
March 264
April 261
May 255
June 264
July 249
August 240
September 234
October 258

Previous Years
2022 3222
2021 3170
2020 3085
2019 3013
2018 2694
2017 2572
2016 2164
2015 1950
2014 2203
2013 2216
2011 2236
2010 2002
2009 2114

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Dec 08, 2023

Application for Membership

Required   Indicates Required Field
Application Info
Date/Time: 12/08/2023 1125
Type of Application: Required New
Reinstatement from Inactive Membership
Check Membership Applying for: Required Cadet (age 14 & 15)
Active (age 18 & up with EMT-B Certification or Higher)
Driver only (age 21 & up)
Reserve (COVID-19 Response)
Administrative (age 18 & up)
Provisional (age 16 & 17 with 1st Responder or higher; or age 18 or higher with EMR)
Associate (current member at another rescue/fire dept. in Tri-County with EMR or higher)
Personal Information
First Name: Required
Middle Initial: Required
Last Name: Required
Date of Birth: Required
Social Security Number : Required
Address: Required
City: Required
State: Required
Zip: Required
Telephone: Required
E-mail Address: Required
Marital Status: Required Single
Additional Information
Do you have a Driver's License?: Required Yes
State Issued:
Have you ever been convicted or posted collateral/bail for any traffic violation: Required Yes
If yes, list all such offences with date, place, and action taken:
Emergency Contact
Contact Name: Required
Contact Relationship: Required
Contact Phone: Required
Background Information (A signed Volunteer Employment 'Consent/Release Form' by St. Mary's County Volunteer Emergency Services is required when this application is received and tabled at the meeting.)
Have you ever been convicted of a misdemeanor or felony or are you under charge(s) for a misdemeanor or felony?: Required Yes
If yes, list all offenses and state date, place and action taken:
Training (Please submit copies of any certifications you hold for any EMS/Fire Training and course work completed including dates of completion and/or expiration.)
Please Include all training Including (Training Level) (MFRI / MIEMSS I.D. Number) (Completed or Expiration Date):
Please add copies of your certifications here:
Add files...
Are you currently employed : Required Yes
Place of Employment:
Are you a member of another Rescue Squad, EMS,ALS or Fire Department?: Required Yes
Have you ever been a member of another RescueSquad, EMS, ALS or Fire Department?: Required Yes
If yes, explain:
Attach a list of all Rescue Squad, EMS,ALS or Fire Department organizations to which you were either a paid and/or volunteer member. Include date (from/to), and any offices held:
Background Check Statement
I understand that in order for my application to move forward and to be tabled I need to submit my Criminal Background Check Release Form: Required Yes

Please read carefully. By submitting this application for membership in the Mechanicsville Volunteer Rescue Squad, Inc., (MVRS), I authorize investigation of all statements contained therein. I hereby authorize MVRS to make any contacts considered necessary for me to become a member, such as current employers, criminal records, etc. It is understood and agreed that any misrepresentation by me in this application, will be sufficient cause for cancellation of the application or for separation from MVRS as a member at any time. I understand that this application is the property of Mechanicsville Volunteer Rescue Squad, Inc., and will become part of my personnel file if I am accepted as a member. Driver record checks may be required in accordance with MVRS insurance carrier's requirements. I hereby authorize MVRS to obtain my complete driving history. POLICY STATEMENT: MVRS is an equal opportunity organization and shall not discriminate against any member or applicant due to age, sex, marital status, national origin, religion, race, physical or mental handicap unrelated to the performance of the job or any other prohibited reasons. The Membership Committee will review this application and additional information developed during background checks. Applicants may be disqualified for criminal conduct. If applicant is less than 18 years of age, a parent or legal guardian MUST submit this application. 

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Mechanicsville Volunteer Rescue Squad, Inc.
28120 Old Flora Corner Road
P.O. Box 15
Mechanicsville, MD 20659
Emergency Dial 911
Non-Emergency: 301-884-2900
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