Get Involved!

Apply to become a member

Get Involved!

Apply to become a member

Becoming A Member

FSSP appreciates your interest in joining the organization. Please fill out the application below, and we will be in touch.

PERSONAL INFORMATION

Name

Legal name (if different)

Street Address

Email Address

Home number

Work number

Cell number

D/O/B

Marital Status

Driver License Number

State

Upload Drivers License Photo

Where do you Daven during the week?

Where do you Daven on Shabbos?

Are you or have you ever been a member of any organizations?

Yes

No

If yes, which one(s)

Summer Months:

Full time city

Upstate for weekends

Upstate All Summer

Employer’s name, address and phone number

Vehicle Make/Model:

Plate #

State

CHARACTER REFERENCE

Ref #1 Name

Ref #1 Address

Ref #1 Number

Ref #2 Name

Ref #2 Address

Ref #2 Number

AVAILABILITY

Which days are you available?

Hours:

Which NIGHTS are you available?

Hours:

MEMBERSHIP TERMS & AGREEMENT

I will patrol on my assigned night(s):

X

I will adhere to the rules and regulations of the FSSP

X

I understand and agree that the radio and/or any equipment assigned to me is the property of the FSSP and must be surrendered upon request.

X

I affirm that I understand the regulations of the FSSP and that the above information and statements are true and accurate

X

Applicant's Name:

Date

Checking this box shall function as an electronic signature:

X

FSSP Coordinator's Name:

Date

Checking this box shall function as an electronic signature:

X

Becoming A Member

FSSP appreciates your interest in joining the organization. Please fill out the application, and we will be in touch.