Apply

Start your application.

Membership applications are accepted online, year-round, from individuals ages 17 and up. After you submit, a Membership Committee representative will reach out to arrange an interview.

Personal infoStep 1 of 5

Personal information

Resume

First nameLast name

Gender

MaleFemale

Address line 1Address line 2(optional)

CityStateZIP

PhoneEmail

Last 4 of SSN(optional)Birth date

Emergency contact

Name

RelationshipPhone

References

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

Personal reference

First nameLast name

Relationship

Phone(optional)Email

Professional reference

First nameLast name

Relationship

Phone(optional)Email

Third reference

First nameLast name

Relationship

Phone(optional)Email

Supplemental questions

Eight short-answer questions to help our membership committee learn more about you. All are required.

1. Why do you want to be a part of Larchmont Volunteer Ambulance Corps?2. How did you hear about Larchmont Volunteer Ambulance Corps?3. Do you have any previous volunteer experience of any kind? If yes, please elaborate.4. Do you have any previous medical or emergency services experience? If yes, please elaborate.5. What are your expectations of membership at Larchmont Volunteer Ambulance Corps?

6. What are you interested in becoming?

7. What is the time investment you are looking to make as a member of Larchmont Volunteer Ambulance Corps?8. Do you have any current or future plans that may limit your ability or time to volunteer? If yes, please elaborate.

Other information

Are you a certified EMT?Do you have a valid driver’s license?

Any known members?(optional)Have you applied previously?Have you previously applied to and been rejected from any other EMS agency, including Larchmont VAC?Are you currently a volunteer member of any other VAC or EMS agency in New York State?Anything else we should know?(optional)

Verification

A non-refundable $25 application fee is due at time of application, payable online after submission.