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04 t COUNTY OF ORANGE <br /> • <br /> APPLICATION FOR EMERGENCY AID AND ASSISTANCE CERTIFICATE <br /> I. Name of Applicant Mebane Fire Department <br /> Address of Applicant P. 0. Box 314 Mebane N. C. 27302 <br /> Name and address of the owner of any vehicle to be used in responding <br /> to the requests for emergency aid and assistance. <br /> Town of Mebane <br /> 106 E- Washington Street, Mebane, N. C. 27302 <br /> U. The trade name, organizational title or other adopted name, if any, <br /> under which the applicant operates n/a <br /> III. List the members or affiliates of the organization, their individual <br /> addresses, the emergency medical training and experiences of each <br /> member (see attached) . <br /> IV. Attach a description of: <br /> A. The training programs of the organization including continuing <br /> medical education and the relationship with area hospitals. <br /> B. The communication capabilities and requirement of the organi- <br /> zation's communication system. <br /> V. Attach a list of the medical equipment and supplies available for use <br /> by the organization--separating zasic Life Support equipment from <br /> Advanced Life Sup ort equipment. <br /> VI. List all sources of income to the organization Alamanoe County, <br /> Town of Mebane, Efland Fire Deportment. and Dpnations , <br /> VII. Other information: <br /> A. Type of service proposed: <br /> Emergency Transportation <br /> Convalescent and Nonemergency Transportation <br /> X First Responder <br /> Rescue <br /> Other (Specify) _ <br /> B. Attach a description of the method and means of providing such <br /> service, including the area to be covered. <br /> VIII. Date of application October 17, 1986 <br />