Online Application

Online Membership Application

If you are interested in joining the Whitestone Community Volunteer Ambulance Service, you can complete this form and the information will be given to the Membership Committee. The Committee will contact you shortly. You may call us at 718-767-1000 and leave your name, telephone number and the best time to contact you.

Application Information

First Name:
Last Name:
Middle Initial :
Sex:
Date of Birth :
Education
Are you interested in?
Certification options that apply
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone: *
Evening Phone:
Email: *
Comments:

Thank you for applying to the Whitestone Community Volunteer Ambulance Service. By pressing the "Submit Form" button above, the information you have entered will be forwarded to the Chairperson of the Membership Committee. The Committee will be contacting you, by phone, within a week or so. Please understand that you will be aked to meet with the Committee for an interview.

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Online Application

Online Membership Application