Fillable Application for Employment Eagle Fire Department

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Application for Employment Eagle Fire Department

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  • 10 check-boxes
  • 142 other fields

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Application for Employment
Eagle Fire Department
An Equal Opportunity Employer
To be considered an applicant, you must complete this form. A resume may also be attached – See job announcement for
application requirements. Each question should be fully and accurately answered. No action can be taken on this application
until all questions have been answered. Use blank paper if you do not have enough room on this application. PLEASE
PRINT, except for your signature. This application is to fill the current open position only.
Personal Information:
Name:
Last
First
Middle
Other Names Used
Address:
Street
City
State
Telephone:
Home
Cell
Email Address:
Position Applying For:
Job Title:
Are you applying for:
⃞ F/T ⃞ P/T ⃞ Temp/Seasonal
What shifts will you work?
⃞ Days ⃞ Nights
May We Contact Present Employer?
⃞ Yes ⃞ No
Available Start Date:
Education/Training
School
Name
Location
Dates Attended
From / To:
Diploma, Degree
& Major
Graduated?
High School
College
Other
(Business,
Vocational,
Military)
Are you legally eligible to work in the United States? Yes No
(Federal Law requires proof of identity and employment authorization for all new employees.)
Can you travel if the job requires it? Yes No
Do you have a valid driver’s license? Yes No State:______
Employment History (Please Start With the Most Recent, Ending With Age 18, Excluding Part-Time Positions Held
While Obtaining Higher Education—Use Additional Paper as Necessary.):
Employer:
Address:
Street
City
State
Zip
Telephone:
Supervisor Name:
Dates From:
To:
Final Rate of Pay:
Position Held:
Primary Duties:
Reason for Leaving:
Next Employer:
Employer:
Address:
Street
City
State
Zip
Telephone:
Supervisor Name:
Dates From:
To:
Final Rate of Pay:
Position Held:
Primary Duties:
Reason for Leaving:
Next Employer:
Employer:
Address:
Street
City
State
Zip
Telephone:
Supervisor Name:
Dates From:
To:
Final Rate of Pay:
Position Held:
Primary Duties:
Reason for Leaving:
Technology Skills (List All Skills & Software Applications You Have Experience Using):
Word Processing:
Spreadsheet:
Other Software:
Database:
Microsoft Office? Yes
No PowerPoint? Yes No
No Copier? Yes No
Scanner? Yes D
Explain Internet Skills, Including Email Usage:
Professional Licenses or Certificates Held:
Military
Are you a veteran or family member who qualifies for and
are claiming preference pursuant to Idaho Code
§ 65-503 or its successor?
Have you previo
usly claimed such preference?
Yes No (If Yes, fill out Page 5 of Application
& attach proper documentation)
Yes No
Personal Reference (Please list the names of three (3) persons not related to you by blood or marriage.)
Name:
Last
First
Middle
Address:
Street
City
State
Zip
Other
Telephone:
Home
Connection To You (i.e. friend, co-worker):
Occupation:
Personal Reference
Name:
Last
First
Middle
Address:
Street
City
State
Zip
Telephone:
Home
Other
Connection To You (i.e. friend, co-worker): Occupation:
Personal Reference
Name:
Last
First
Middle
Address:
Street
City
State
Zip
Telephone:
Home
Other
Connection To You (i.e. friend, co-worker): Occupation:
Have you ever been convicted of a crime (other than a minor traffic infraction)? Yes No
If yes, when & where: _______________________ Please Explain: ________________________________________
Are you related by blood or marriage to any person now employed by the Eagle Fire Department? Yes No
If yes, give name and relationship to you:
MAY WE CONTACT YOUR PRESENT EMPLOYER?
Yes No
Please Read Carefully
APPLI
CATION FORM WAIVER
In ex
change for the consideration of my job application by Eagle Fire Department (hereinafter called “the
Department”), I agree that:
I authorize investigation of all statements contained in this application, including investigation of driving and
criminal background records. I understand that the misrepresentation or omission of facts called for is cause for
dismissal at any time without any previous notice. I hereby give the Department permission to contact schools,
previous employers (unless otherwise indicated), references, and others, and hereby release the Department from
any liability as a result of such contact.
I also understand that (1) the Department has a drug and alcohol policy that provides for pre-employment testing as
well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment;
and (3) continued employment is based on the successful passing of testing under such policy. I further
understand that continued employment may be based on the successful passing of job- related physical
examinations.
I further understand that my employment with the Department shall be probationary for a period of one (1) year, and
that adverse items on my driving and criminal records may be cause for dismissal at any time without previous
notice.
Signature of applicant Date:
This
Department is an equal employment opportunity employer. We adhere to a policy of making employment
decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or
disability. We assure you that your opportunity for employment with this Department depends solely on your
qualifications.
Than
k you for completing this application form and for your interest in our business.
click to sign
signature
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VETERAN’S PREFERENCE
If you are NOT claiming Veteran’s Preference, please initial here _____.
Per Idaho Code, Title 65, Chapter 5, Employer will afford a preference to employment of veterans. In the event of equal
qualifications and experience between candidates for an available position, a veteran who qualifies will be preferred. If
claiming veteran’s preference, please complete the information below and attach a copy of your DD-214 to this application.
------------------------------------------------------------------------------------------------------------------
(Reference Idaho Code, Title 65, Chapter 5, and 5 U.S.C. § 2108)
The term “active duty” means full-time duty in the Armed Forces, but NOT active duty for training.
Part 1. Preference Eligible Veterans:
⃞ I have a service-connected disability of 10% or more.
⃞ I am the spouse of an eligible disabled veteran, who has a service-connected disability.
⃞ I am the widow or widower of an eligible veteran and have remained unmarried.
⃞ I do not meet any of the selections above, but I served on active duty in the armed forces of the United States for a
period of more than one-hundred eighty (180) days and was honorably discharged.
Part 2. Documentation & Signature:
By my signature, I certify that all statements on this form are true and complete to the best of my knowledge. I understand
that should an investigation disclose inaccurate or misleading answers, my application may be rejected and my name
removed from consideration for employment with Employer.
⃞ I have attached a copy of my DD-214. Veteran’s preference will not be considered without this document.
_____________________________________________________ ________________________________________________
Name (Please Print) Signature
DATE: _______________________________________________
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signature
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Application for Employment Eagle Fire Department

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Completed 27 August 2021

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