Mechanicsville Volunteer Rescue Squad, Inc.




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Auxiliary Membership Application

Required   Indicates Required Field
Name (Last, First, Middle): Required
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Date of Birth: Required
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Next of Kin Name: Required
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Date of Application: 02/20/2019 1136
Signature of Applicant: Required
Note: You must attend three membership meetings before you are eligible for membership
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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
E-mail: info@co29.org
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