SVRS On-line Application
Please fill out the application located below. When you are finished filling out the application, please press Submit. Please send any questions or comments to membership@SVRS25.com.

Dear Applicant,
On behalf of the Strasburg Volunteer Rescue Squad, Inc., I would like to thank you for applying for membership into one of the oldest volunteer rescue squads in Shenandoah County and in the Commonwealth of Virginia.

Your application will be tabled for thirty (30) days at a regular monthly meeting of the corporation. During this time, the membership committee will contact you to schedule a personal interview. Your application will be voted on at the next regular monthly meeting of the organization. You will be notified in writing of your acceptance or denial for probationary membership.

Please complete the application for membership and attach photocopies of certifications that relate to Emergency Medical Services (EMS).

As you complete your application, I would like to brief you on several rules and regulations of our organization. If you are accepted into membership, you will be placed on probation for a six (6) months period. At the end of your probation, the organization's membership will vote on your application. You may be voted into full membership or denied membership.

All members must attend monthly membership meetings which are held on the first Monday of each month unless it falls on a holiday, then it will be held on the following Monday.

All probationary members will meet with the training officer who shall assign a member to assist with your training. You will need to cpmplete an orientation and required training prior to actively running emergency calls. As a reminder, each member is required to pull 12 hours of duty per month.

Probationary members under the age of eighteen (18) must have a parent/guardian sign the application and submit a letter granting permission to pull duty from the squad headquarters. Your parent/guardian must be present for the personal interview.

Any questions or concerns, please contact me at the squad headquarters. The phone number is (540) 465-8272. The physical location is 156 East Washington Street.

Sincerely,
Courtney Gasch
Administrator of Membership


STATE BOARD OF HEALTH
VIRGINIA EMERGENCY MEDICAL SERVICES REGULATIONS

These regulations are scheduled to be published in the Virginia Register on October 18, 2002 and have an effective date of January 1, 2003.

12 VAC 5-31-910. Criminal or enforcement history.


EMS personnel shall meet and maintain compliance with the following general requirements:
1. Has never been convicted or found guilty of any crime invovling sexual misconduct where the lack of affirmative consent by the victim is an element of the crime, such as forcible rape.
2. Has never been convicted of a felony invovling the sexual or physical abuse of children, the elderly or the infirm, such as sexual misconduct with a child, making or distributing child pornography or using a child in a sexual display, incest invovling a child, assault on an elderly or infirm person.
3. Has never been convicted or found guilty of any crime (including abuse, neglect, theft from, or financial exploitation) of a person entrusted to his care or protection in which the victim is a patient or is a resident of a health care facility.
4. Has never been convicted or found guilty of any crime invovling the use, possession or distribution of illegal drugs except that the person is eligible for affliation five years after the date of final release if no additional crimes of this type have been committed during that time.
5. Has never been convicted or found guilty of any other act that is a felony except that the felon is eligible for affliation five years after the date of final release if no additional felonies have been committed during that time.
6. Is not currently under any disciplinary or enforcement action from another state EMS office or other recognized state or national healthcare provider licensing or certifying body. Personnel subject to these disciplinary or enforcement actions may be eligible for certification provided there have been no further disciplinary or enforcement actions for five years prior to application for certification in Virginia.
7. Has never been subject to a permanent revocation of license or certification by another state EMS office or other recognized state or national healthcare provider licensing or certifying body.
B. EMS personnel may not act as an operator of an EMS vehicle if they have been convicted upon a charge of driving under the influence of alcohol or drugs, convicted of a felony or assigned to any alcohol safety action program or driver alcohol rehabilitation program pursuant to SS 18.2-271.1, hit and run, or operating on a suspended or revoked license within the past five years. A person having any of these convictions in Virginia or another state may be eligible for reinstatement as an operator after five years and after successful completion of an approved emergency vehicle operator's course (EVOC) within the year prior to reinstatement. C. All references to criminal acts or convictions under this section refer to substantially similar laws or regulations of any other state or the United States. Convictions include prior adult convictions, juvenile convictions and adjudications of delinquency based on an offense that would have been, at the time of conviction, a felony conviction if committed by an adult within or outside Virginia.

This document is copied by permission from the Virginia Department of Health, Office of Emergency Medical Services rules and regulation effective January 1, 2003. By signing this document, I verify that I am not in violation of the 12 VAC 5-31-910. Criminal or enforcement history rules and regualtions.

(You will need to sign this document at the end of the application).

SVRS On-Line Application