West Windsor Fire Company, Inc.  Jerryl Launt, Chief John West, President 9Karla Drive Windsor, N.Y. 13865 Windsor Town Board 124 Main. Street Windsor, N.Y. 13865  28-Aug-23 Date  RECEIVED 3027.5823 OFFICL OET WIMDSOILIY THETVENICLERK  Thej following person has applied fori membership in the West Windsor Fire Company. Having been cleared throuhg Broome County Office of Emergency Services, please confirm or reject the applicant  listed below and return the bottom portion of this form.  Applicant Name Boerner  Jamie First  B Middle Initia!  Last 226 Springer Rd. Street Binghamton Town  Phone 8/11/1994 Date of Birth S.S.# 15-Aug-23  NY State  13904 Zip  BROOME COUNTY, EMPLOYEE HEALTH. SYSTEM PHYSICAL  Clearance through Broome County OES  Chief  Cut Here  Name of Applicant  Boerner, Jamie  Accepted Denied  Date Return To:  Windsor Town Clerk  West Windsor Fire Company Inc. 9 Karla Drive Windsor, N.Y. 13865  Revised 1-4-2022