Larchmont Volunteer Ambulance Corps
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Application

    Application Instructions


    Thank you for taking the time to apply to Larchmont Volunteer Ambulance Corps. Please carefully complete all required sections of the application below. The application will take about 30 minutes to complete.  

    Upon submitting this application you will be redirected to another page to pay our non-refundable $25 application processing fee.

    If you have any difficulties or questions about completing our application please e-mail us. 



    Max file size: 20MB
    Please upload a PDF file only
    Personal Information
    Please do not use any aol.com address. Our mail system currently blocks it due to the high amount of spam.

    Emergency Contact Information

    References

    We require at least two references to complete this application. A personal reference (friend, family, etc) and a professional reference (teacher, employer, coach, etc.) are both required. Your third reference can be either. 

    Supplemental Questions 

    Below are 8 required short answer questions to help our membership committee learn more about you the applicant. All 8 questions must be completed to submit this application. 

    Other Information
    By submitting this form I herby give permission to the Town of Mamaroneck/ Village of Larchmont Volunteer Ambulance Corps to verify information concerning my character and advise you thereof for the purpose of becoming a member of the Town of Mamaroneck/ Village of Larchmont Volunteer Ambulance Corps.  A routine inquiry may be made into this application to provide us with information concerning your personal character.  It is also noted that if I am under 18  years of age my parents or legal guardians approve of this application.

    I understand that any false statements made hereon will automatically disqualify me from membership in the Town of Mamaroneck/ Village of Larchmont Volunteer Ambulance Corps.
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