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Personal Information


Do you have a professional driving license?

Qualification or Specialised Training (please list your qualification or experience e.g. Medical Dr)

Qualifications or Interests

Tick the areas you are qualified in or if you are interested in learning

Medical, Rescure, Fire

List membership of other groups in particular emergency services volunteers, disaster relief etc (e.g. St John, NSRI, VWS, Youth or church groups.

Next of Kin

Medical Information

Employment Information

​​Uniform/Clothing Sizes

What is your hand size?


  1. I declare that I have read and understood the Code of Conduct attached to my application, and confirm that I will abide by the Code of Conduct at all times;

  2. I confirm that I have not been coerced into joining EVS and its CERT units, and do so of my own free will;

  3. I confirm that I agree to serve my community and EVS for a minimum of two years given that a great deal of time, effort and cost is invested in my training and that I will accrue valuable skills and expertise;

  4. I confirm that I have no medical condition that prevents me from engaging in work of a physical nature and that I have fully declared my medical conditions, if any;

  5. I confirm, that I indemnify and will not hold liable EVS and CERT, its officials, office bearers, team leaders. board members and management team, and associated entities, for any and all claims arising from any injury, whether wilfully inflicted or via negligence, arising from participation in training activities, and / or other EVS related work at incidents or stand-bys including travel by EVS or personal transport;

  6. I confirm that(in the case of applicants from schools/minors) that I have my parent/guardian permission to participate in EVS/CERT activities.

By clicking submit you acknowledge that you have read and understood the above declaration.

Postal Address:

PO Box 363

Newlands 7725

Physical Address:

39 De Villiers Road

Kommetjie 7975

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Tel: 083 460 3898


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