Click on the link below to access the Midlothian Fire Cadet Program Application. For more information about the cadet program contact: Ms. Liesl Behrens  email : lbehrens@bhsd228.com
 
 
 

Bremen High school / Midlothian Fire Department                                                                        Fire Cadet Application

Applicant Information

Name:

Date of Birth:

SSN:

Phone:

Address:

City:

State:

Zip Code:

Student Information

Are you involved in any sports, clubs, or other activities at school or in the community?

 

 

 

Emergency Contact  info

Name and Relationship:

Address:

Phone:

City:

State:

ZIP Code:

Have you ever received any disciplinary action from your school?        Yes           No

If yes, please explain:

 

Please Write a brief DESCRIPTION:

“Why I want to become a Midlothian Fire Cadet and what qualities I will bring to the Cadet Program”

 

 

 

 

 

 

 

 

Please submit two references with SIGNATURES

        Please obtain TWO non-relative referEnces (ie: Counselors, Teachers, Deans, Coaches, work)

Name ( Printed ) and Signature

Title

Phone

1.

 

 

2.

 

 

Signatures

My signature indicates that I have filled out the above information to the best of my knowledge. If accepted into the Midlothian Fire Cadet Program, I will conduct myself with self-discipline and respect to my community.

Signature of Applicant:

Date:

Parent Signature:

Date:

 

 
 
 
CLOSE