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Palm Beach County Fire Rescue
CADET BATTALION
Application Form
Cadet Information
Please complete the following form completely. Do not leave any field blank. Enter "N/A" if not applicable
Cadet First name
Cadet Last name
Cadet Email
Cadet Phone
Birthday
Current age
Last 4 digits of SS#
Do you have a valid drivers license
Choose an option
Drivers License Number
If yes, in which state was it issued
Drivers License Expiration Date
Street Address
City
Region/State/Province
Postal / Zip code
Reffered by (Include name, relationshipt to person, and if they work for PBCFR)
Are you related to a PBCFR employee
*
Yes
No
If yes, Who
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