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I, the undersigned, applying for the membership with the Dalhart Volunteer Fire Department, do hereby certify that the answers to the above questions are true and correct. I understand that any false answers will be grounds for dismissal and I agree to hold the Department and/or the City of Dalhart blameless for such dismissal. I also agree to undergo a physical examination, giving the examining physician permission to contact my personal physician, and allowing the examining physician to submit his findings to the Department, the Pension Board and/or the City of Dalhart. Furthermore; I understand that this application is subject to approval by the Officers of the Department and Pension Board.
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