All applicants must certify to these statements, which are a condition of membership. Full membership in Waterbury Ambulance Service, Inc., is determined by vote of the squad after a candidate has served for at least six months.

• I CERTIFY THAT THE FACTS GIVEN ON THIS APPLICATION ARE CORRECT AND TRUE, TO THE BEST OF MY KNOWLEDGE. I HAVE WITHHELD NOTHING THAT, IF DISCLOSED, COULD AFFECT THIS APPLICATION. I UNDERSTAND THAT IF WATERBURY AMBULANCE SERVICE, INC., APPROVES MY APPLICATION, ANY FALSE STATEMENTS IN THIS APPLICATION ARE GROUNDS FOR DISMISSAL. 
• I UNDERSTAND THAT MEMBERSHIP REQUIRES THE RESPONSIBILITY OF FILLING A MINIMUM OF FIVE 12 HOUR SHIFTS PER MONTH. I AGREE TO BE AVAILABLE AS SCHEDULED UNLESS I HAVE BEEN EXCUSED FROM THIS MINIMUM. I UNDERSTAND THAT, WHILE THE SQUAD WILL BY TO ACCOMMODATE MY NEEDS, I MAY NOT BE ASSIGNED TO MY CHOICE OF SHIFTS. 
• I FURTHER UNDERSTAND THAT PARTICIPATION ON THE SQUAD REQUIRES ME TO ACT PROFESSIONALLY AND COURTEOUSLY TOWARD PATIENTS AND OTHER SQUAD MEMBERS. 
• IF ACCEPTED FOR MEMBERSHIP, I AGREE TO FOLLOW ALL THE WATERBURY AMBULANCE SERVICE, INC., PROCEDURES, POLICIES, AND PROTOCOLS, TO THE BEST OF MY ABILITY.

All applicants must certify to these statements, which are a condition of membership. Full membership in Waterbury Ambulance Service, Inc., is determined by vote of the squad after a candidate has served for at least six months.

• I CERTIFY THAT THE FACTS GIVEN ON THIS APPLICATION ARE CORRECT AND TRUE, TO THE BEST OF MY KNOWLEDGE. I HAVE WITHHELD NOTHING THAT, IF DISCLOSED, COULD AFFECT THIS APPLICATION. I UNDERSTAND THAT IF WATERBURY AMBULANCE SERVICE, INC., APPROVES MY APPLICATION, ANY FALSE STATEMENTS IN THIS APPLICATION ARE GROUNDS FOR DISMISSAL. 
• I UNDERSTAND THAT MEMBERSHIP REQUIRES THE RESPONSIBILITY OF FILLING A MINIMUM OF FIVE 12 HOUR SHIFTS PER MONTH. I AGREE TO BE AVAILABLE AS SCHEDULED UNLESS I HAVE BEEN EXCUSED FROM THIS MINIMUM. I UNDERSTAND THAT, WHILE THE SQUAD WILL BY TO ACCOMMODATE MY NEEDS, I MAY NOT BE ASSIGNED TO MY CHOICE OF SHIFTS. 
• I FURTHER UNDERSTAND THAT PARTICIPATION ON THE SQUAD REQUIRES ME TO ACT PROFESSIONALLY AND COURTEOUSLY TOWARD PATIENTS AND OTHER SQUAD MEMBERS. 
• IF ACCEPTED FOR MEMBERSHIP, I AGREE TO FOLLOW ALL THE WATERBURY AMBULANCE SERVICE, INC., PROCEDURES, POLICIES, AND PROTOCOLS, TO THE BEST OF MY ABILITY.