Apply to serve with Tie Plant VFD.

Submit your initial information for leadership review.

Initial application

No website account is required. This form begins the application process and does not guarantee membership.

Do not submit a Social Security number, driver-license number, medical records, or beneficiary information here.

Applicants selected to continue will complete the department’s signatures, consent forms, beneficiary designation, and any required notarized paperwork directly with leadership.

Return to recruitment information

Applicant information

Website

First nameMiddle name OptionalLast name

Date of birthPhone number

Email addressStreet address

CityStateZIP code

Department information

Current employer OptionalTime available to volunteer OptionalDepartment sponsor Optional

Do you have a valid driver’s license? Yes No

Driver’s-license image Optional · JPG, PNG, or WebP · 5 MB maximumRestricted identity document. Only authorized leadership can view it, and it is removed when the application is approved or declined.

Have you ever been convicted of a crime? No Yes

If yes, explain Required when applicableTraffic violations within the last five years OptionalI confirm that this information is accurate and understand that this is an initial application, not guaranteed membership.

Tie Plant VFDGrenada County, Mississippi

22455 Hwy 8 E, Grenada, MS 38901

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For emergencies, call 911.