Application for Volunteer Firefighter Recruit

First Name (required)

Last Name (required)

Middle Name

Date of Birth (required)

Last 4 of Social Security Number (required)

Present Address (required)

Home Phone Number

Cell Phone Number (required)

Email Address (required)

Do you or your spouse have any friends or relatives wo work for the Deer Creek Fire Protection District? (required)

Yes

If yes, Please give their name

Relationship to current firefighter?

Have you ever been employed with Deer Creek Fire Protection District? (required)

Yes

If yes, please give date of Employment from and to

If yes, Please give the reason for leaving

Have you previously filed an application with the Deer Creek Fire Protection District? (required)

Yes

If yes, Please give the date you previously applied

Have you ever been arrested? (required)

Yes

If yes, Please list the reasons/charges/dispositions/date of charges

Education

Please Select your highest level of education

Highschool (required)

Graduated

High school Name

High school location (City,State)

If not graduated from high school, do you have a GED?

Yes

Please describe any courses, programs, or other activities you participated in that relate to the position you are applying for

Vocational/Technical Institute Name

Location (City,State)

Did you graduate?

Yes

College Name

Location (City,State)

Did you graduate?

Yes

College 2 Name

Location (City,State)

Did you graduate?

Yes

Employment History

Instructions: List all employment for which you have worked in the last five (5) years, starting with the most recent or current employer. Please provide start and end dates for each job. Describe all job duties performed, especially those which demonstrate your qualifications for the position to which you are applying. A RESUME IS NOT A SUBSTITUTE FOR THE INFORMATION REQUESTED BELOW. A resume may be attached as a supplement to the information given below. Failure to provide the requested information my result in disqualification from active consideration. Type as much as needed. (required)

References

Instructions: Please provide three (3) professional references and one (1) personal reference. Please do not incude family references unless you work directly for them. (required)

IMPORTANT - PLEASE READ AND SIGN

I understand that all information submitted is subject to verification. I understand and authorise the Deer Creek Fire Protection District to conduct verification and/or investigation as deemed necessary to determine my qualifications for employment.I certify that all statments and answers to all questions in this application are true, complete, and correct and are made in good faith. I understand that falsification of any answers I have given will have serious consequences, including disqualification for employment and/or termination of employment. PLEASE PRINT YOUR FULL NAME IF YOU UNDERSTAND AND AGREE. (required)

please attach your resume, certifications, or any other supplements you may have for consideration.

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