Online Application Form

Fill out the form below and click the "View Completed Application" button. A popup window will appear with your completed application. Please send the completed application via email to: applications@diverescue77.org

A Chief Officer will contact you back with futher information within 72 hours.

Disclaimer: Please note that a submitted application does not equate to automatic Team membership. After submitting an application all applicants must undergo at a minimum a Criminal Background Check and as personal interview plus possibly a physical examination, skill testing or written proof of certifications/training prior to membership being granted or rejected.


Personel Information





















Emergency Contact Information






Background Information






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