Full Membership Application

Thank you for your interest in becoming a member of the Westhampton Beach Fire Department.

This page contains the full membership application, which is the next step in the membership process. Please take your time to complete the application in full and provide accurate information. All submissions are reviewed by department leadership as part of the membership evaluation process.

Submission of this application does not guarantee acceptance into the department, but allows us to move forward with the formal review process.

Membership Application

Position Applying For(Required)

Name(Required)

Email Address(Required)

Date of Birth(Required)

Last 4 digits of Social Security #(Required)

Current Address(Required)

Time at this residence(Required)

Do you have a valid New York State driver's license?(Required)

Yes

Do you have a high school diploma or equivalent?(Required)

Yes

Have you ever been convicted of arson?(Required)

Yes

Do you have any physical ailments that would impair your activities as a firefighter?(Required)

Yes

Signature(Required)

Interview Preparation Checklist

Please bring the following items with you to your interview:

New York State driver’s license (with photo)

AND one (1) of the following forms of identification:

Birth certificate
Passport
Government-issued photo ID

The Next Step in Joining the Westhampton Beach Fire Department

Membership Application

Interview Preparation Checklist