Three Star Volunteer Fire Department
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Volunteer Firefighter
THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT
but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a pre-employment drug screening and/or medical examination. This application will remain active for 3 years.
Personal Information
First Name
Middle Name
Last Name
Home Phone
Work Phone
Cell Phone
Email Address
Addresses
Street
City
State
Zip Code
Since (Mo/Yr)
To (Mo/Yr)
Current Address
Prior Address
Prior Address:
Education
School Attended
City
State
Diploma
Degree/Cert.
Area of Study
High School
No
Yes
GED
Undergrad School
No
Yes
Grad School
No
Yes
Other School
No
Yes
Employment Information
Position Applied For
Date You Can Start
(yyyy-mm-dd)
Can you work
Weekends
Evenings
Available:
M
Tu
W
Th
F
Sa
Su
Are you available for shift work?
No
Yes
Not Available
Please answer all of the following questions.
1.
Are you at least 18 years of age and legally eligible to work for our company in the United States?
No
Yes
If you are under 18 years of age, can you provide required proof of your eligibility to work?
No
Yes
2.
Have you worked for this business before?
No
Yes
If yes, please provide dates and locations.
3.
Have you received a description of the job or been made aware of the essential functions of the job for which you are applying?
No
Yes
4.
Do you understand the job requirements?
No
Yes
If no, please explain.
5.
Are you on layoff and subject to recall?
No
Yes
6.
Are you currently bound by a noncompetition, confidentiality or trade secret agreement?
No
Yes
If yes, please explain...
7.
Have you ever been discharged or asked to resign from a job?
No
Yes
If yes, please explain...
8.
Have you ever been convicted of or pled guilty to a felony or crime other than a minor traffic citation?
No
Yes
If yes, please explain...
9.
Do any of your friends or relatives, other than spouse, work here?
No
Yes
If yes, state name and relationship...
Employment History
Are you currently employed?
No
Yes
May we contact your present employer?
No
Yes
Most Recent Employer
Prior Employer
Prior Employer
Prior Employer
Employer
City
State
Zip Code
Phone
Position Held
From (m/yyyy)
To (m/yyyy)
Supervisor
Duties
Reason For Leaving
Job-related Skills
Please answer the following questions if the position you are applying for requires driving a motor vehicle
1.
Do you have a valid driver's license?
No
Yes
If yes, Driver's License Number
Date of Issue
2.
Have you been convicted of or pled guilty to any traffic-related offense within the past five years?
No
Yes
If yes, please explain...
3.
Have you had your driver's license suspended or revoked or had your driving privileges modified by a court of law?
No
Yes
If yes, please explain...
4.
Please list all states from which you hold or held a driver's license
5.
Please use this space to list any special skills you may have that relate to the position applied for
6.
Please list any professional licenses, designations, certifications, etc. that may relate to the position applied for. Include date granted, name of organization, and any other relevant information.
References
Reference (1)
Reference (2)
Reference (3)
Reference (4)
Name
Address
Telephone
Relationship
Years Acquainted
Applicant Certification Agreement
1.
The company and other persons or employers are released from all liability brought forth by any investigation resulting from my submission of this electronic application and the data contained here in.
2.
The information in this application is true and complete to the best of my knowledge. Any falsification, misrepresentation, or omission on this application can be cause for denial or termination of employment.
3.
If hired, my employment is voluntary, meaning that either party can refuse employment at any time for any reason. Upon acceptance of employment if a position is offered, I agree to abide by all existing and future Fire Department rules and regulations. The company reserves the right to change any working agreement as deemed necessary.
4.
I have read and reviewed the information provided in this application and the above statements. By signing this application for employment I certify that I understand all parts of it and have answered all questions completely and fully.
5.
I understand that by typing my name in the signature box below and submitting this application electronically, this becomes a legal and binding contract.
Security Code
Type Name in Signature Box:
Date:
2024-11-13 19:33:57
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