Full Middle Name Home Address (no PO Box) City State Zip Code Phone Email Are you legally authorized to work in the U.S.? Yes No Are you 18 years of age with a high school diploma or GED? Have you ever served with the Tawakoni Fire Dept? If yes, please provide reason for separation, Fire Chief name and dates Have you ever served on a voluntary/paid Fire Dept or EMS Company? If yes, please provide Fire or EMS, Dates, City, and State Have you held a Fire or EMS Certification in any state? If yes, please list any previous or current Fire or EMS, certifications including expiration year, City, and State issued Have you ever held any public safety certifications which do not pertain to firefighting or EMS? If yes, please list any public safety certifications Please list your availability (check all that apply). Be as accurate as possible accounting for work, personal, and family obligations. Are you available for train/meetings on Sundays between 5pm and 10pm at least two times per month? Membership Application Acknowledgement of Truth and Acceptable Use.
By checking below, I, the applicant listed above, hereby certify that the above information entered on this membership application is true and correct to the best of my ability. I also permit the Tawakoni Fire Department and/or representatives to contact me or others listed to verify information or further communicate my status as an applicant. I may cancel this membership application at any time by contacting the Tawakoni Fire Department in writing by email to email@example.com.
I acknowledge the receipt and understanding of the Tawakoni Fire Department Membership Application Acknowledgement of Truth and Acceptable Use. Background Packet
Due to the sensitive and personal nature of the services we render, the Tawakoni Fire Department feels it is our responsibility to ensure that the men and women who serve our residents are of outstanding morale aptitude, both personally and professionally. As such, please complete this next section as accurately and truthfully as additional information will be obtained by the Tawakoni Fire Department and/or its designees. Any inaccuracies, rather intentional or accidental, will likely lead to the immediate dismissal of your application to this department.
Date of birth MM/DD/YYYY City and State of birth Drivers License Number State Issued Other Names Used List all places of residence starting with the most current for the past five (5) years. Make sure to include full addresses. List all motor vehicle accidents and/or moving violation tickets received in the past (10) years. Make sure to include city/state, month/year, and description of event. List all criminal charges, despite outcomes, including charges which were later reduced or dismissed by a court or district attorney, include arrest date and arresting agency/name. Employment Information
Below list your previous (3) employers, starting with the most recent/current. If any information is unknown, please type UNKNOWN only after making every attempt to obtain said information.
Employer 1 Name, Address, City, State Employer 1 Start Date Employer 1 End Date Employer 1 Reason for Leaving Employer 2 Name, Address, City, State Employer 2 Start Date Employer 2 End Date Employer 2 Reason for Leaving Employer 3 Name, Address, City, State Employer 3 Start Date Employer 3 End Date Employer 3 Reason for Leaving References
List three (3) personal references, excluding family members. List only those you have email and phone numbers for.
Reference 1 Name and Relationship Reference 1 Email and Phone Number Reference 2 Name and Relationship Reference 2 Email and Phone Number Reference 3 Name and Relationship Reference 3 Email and Phone Number Background Packet Acknowledgement of Truth and Acceptable Use
By checking below I, the applicant listed above, hereby certify that the above information entered on this background packet is true and correct to the best of my ability. I also permit the Tawakoni Fire Department and/or its representatives to contact me or others listed to verify information, including detailed employment records, or further communicate my status as an applicant. I also permit the Tawakoni Fire Department and/or its representatives to obtain detail records from any public and/or private databases including, but not limited to, state/federal drivers license, motor vehicle registration, and/or criminal history databases. I may void this background packet at any time by contacting the Tawakoni Fire Department in writing by email at firstname.lastname@example.org.
I acknowledge receipt and understanding of the Tawakoni Fire Department Background Packet Acknowledgement of Truth and Acceptance Use Notification