Dear Prospective Member,
Thank you for expressing interest in joining the Loudoun County Volunteer Rescue Squad (LCVRS). This Page contains the forms and instructions necessary to get you started.
For the first phase of the application process:
- Complete the Online Application for Membership below and submit the application. You will receive a copy of your submitted application by email. You will also be contacted by a member of our membership committee by email to provide you with additional information about the second phase of the process.
- Download and complete the following forms:
- Driver Information Request Form – Fill in the “Subject’s Personal Information” and “Subject’s Driving Information” sections of the DMV Information Request. Be sure to include your driver’s license number and sign and date the Driver’s Authorization. Do NOT fill in the top section entitled “Requestor Information.” Include a photo copy of a current driver’s license. If you do not have a driver’s license, please include a copy of a current learner’s permit, DMV issued identification card, or other official government issued identification.
- Criminal History Record Form – Complete Section 3 only (Name to be Searched section). Your signature is NOT required on this form.
- Ride Along Agreement Form – This is an optional form. If you wish to participate in a ride-along during the application process, complete the Ride-Along Agreement.
Return the completed forms and photo identification to our rescue station located at 143 Catoctin Circle SE Leesburg or mail to:
Attn: Membership Committee
PO Box 1178
Leesburg, VA 20177
If you have any questions, please call us at 703-777-7185, email us at email@example.com, or visit our website at www.loudounrescue.org.