Leonardtown Volunteer Rescue Squad

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Online Application


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2024 Incidents
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Mar 238
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2015 2414
2014 2309
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2009 2192
2008 2162
2023 2957 2007 1882
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Membership Application


We are pleased that you are interested in joining our team. The Leonardtown Volunteer Rescue Squad (LVRS), Sta Mary's County Company 19, was formed in 1975 as a 100% volunteer organization to provide emergency medical services to the citizens of Leonardtown and the surrounding communities. Currently we run an average of 2800 + calls per year. We have 3 ambulances and a EMS response vehicle. Our company members range in age from 16 to 70.

Individuals age 16 and older are invited to join the LVRS. Our monthly drill is held on the first Tuesday of the month and the business meeting is held on the third Tuesday. Training is a no cost to the individual. The Emergency Medical Technician (EMT) course is 165-hour course and is offered semiannually locally.

All members must service a 1-year probationary period and meet the requirements of membership status that they are applying for. Exceptions may be made for certified member applicants coming from another St. Mary's County EMS department and may serve a 6-month probation.

Regular membership requires an individual to stand two 8 hr. duty shifts per month and at least two scheduled standbys annually. In addition, member must attend a minimum of 3/4 of the meetings and drills held in a squad year.
Associate membership requires individual to stand 10 hours of duty per month and at least two scheduled standbys annually. Individual is required to attend at least 6 meetings and/or drills a squad year.
Junior Membership is for applicants 16 or 17 yrs. Parent permission and work permit required.

The application package shall include the signed Squad application, a Squad health certificate, a copy of the applicant's driving record and request for Criminal background check form. Members applying for Junior Membership must also provide a work permit and the application must be signed by a parent or legal guardian. Applicant's under 18 years old do not have to summit a background request form. Application will be presented to the membership at the next scheduled business meeting and will be tabled for 30 days. Your presence is required, and all documents must be complete. Once the application is reviewed and processed by membership committee your application will be presented for membership vote. At that business meeting you may become a member of LVRS! We welcome you!

 

Required   Indicates Required Field
Type of Membership Requested: Required
Personal Information
Name (First, Middle, Last): Required
Address: Required
Home Phone:
Work Phone:
Mobile Phone:
Email Address: Required
Birth Date: Required
Social Security Number:
Background Information
Fire / EMS involvement previously: Required
If yes, please specify company:
Highest Rank Served:
Dates (From / To):
LOSAP (From / To):
LOSAP Number:
Contact Name & Phone:
Employer Name & Address: Required
School Attending:
If under 18, list grade:
Work Permit Number (If under 18):
Drivers License Number:
Issuing State:
Expiration Date:
Current Points on your License:
Training Record - Please upload a copy of your training record:
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Character References - List three (3) who are not related to you
Character Reference #1 (Name - Phone): Required
Character Reference #2 (Name - Phone): Required
Character Reference #3 (Name - Phone): Required
Emergency Contacts - List Two (2)
Emergency Contact #1 (Name - Relationship- Phone): Required
Emergency Contact #2 (Name - Relationship- Phone): Required
How did you hear about us?
Please tell us how you heard about the squad: Required
Electronic Signature
Please Type Your Signature Here: Required
By signing above using an electronic signature, I signify that I have applied for the membership to the Leonardtown Volunteer Rescue Squad; that I have answered all questions truthfully and to the best of my knowledge; and that I fully understand that any intentional false statement may be grounds for dismissal from the Leonardtown Volunteer Rescue Squad. Furthermore, I hereby grant to Leonardtown Volunteer Rescue Squad permission to investigate my driving record, medical history as well as my criminal background.
 
I understand that all of this information will be kept confidential.
 
Please print the following link for the health certificate. Have your doctor fill out the information needed. Once filled out fully, turn in the health form to the Leonardtown Volunteer Rescue Squad to complete your application. We are unable to move forward with your application process until the online membership application and the health form are both filled out completely.

 

Click HERE to Download Health Certificate Request

Click HERE to Download Volunteer Employment Consent/Release Form





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Leonardtown Volunteer Rescue Squad, Inc.
PO Box 299
22855 Lawrence Ave
Leonardtown, MD 20650
Emergency Dial 911
Non-Emergency: (301) 475-8509
E-mail: info@lvrs.org
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