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Pasadena Fire Department (City of Pasadena, Texas)

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The Pasadena Fire Department (City of Pasadena, Texas) form is 6 pages long and contains:

  • 3 signatures
  • 24 check-boxes
  • 107 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Pasadena, Texas

BROWSE CITY OF PASADENA, TEXAS (TX) FORMS

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Pasadena Fire Department
923 Shaw Ave.
Pasadena, TX 77506-1519
(713) 475-5554 • Fax: (713) 475-5546
To whom it may concern:
Attached is my application for membership with the Pasadena Volunteer Fire
Department. I have given my full name, address, and other pertinent information as
requested. I understand that this application must be completed in its entirety in
order to receive consideration.
I certify that I have carefully completed this application, and that I have given all
information herein
without omission or falsification. I further attest that no information
has been withheld about me or my background which may cause concern to you in
any way, should you give me membership with the Pasadena Volunteer Fire
Department.
I also certify that I am at least eighteen (18) years of age; a citizen or legal resident
of the United States; a resident of Pasadena or its vicinity; hold a current Texas
driver’s license; have a soci
al security number; and have a high school diploma or
GED equivalent.
By signing my name to this letter, I consent to the investigation of all facts and
circum
stances given in the attached application for membership to the Pasadena
Volunteer Fire Department. I also consent to the interview of any references
provided herein, and to any background investigation needed by any Police
organization. I understand that I am subject to an agility test, a physical
examination, and a drug screen.
I fully understand that should any information found herein be investigated and
found to be false, that I will be subject to immediate dismissal from the Pasadena
Volunteer Fire Department Academy or the Pasadena Volunteer Fire Department
itself without recourse.
Applicant’s Signature Date of Application
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Pasadena Fire Department
Application for Membership
Please PRINT all information in block capital letters.
Personal Information
Last Name: First Name: Full Middle Name:
Current Address (No PO Boxes):
Sex:
Male
Female
Home Phone: Work Phone:
Cell Phone:
Alternate Phone: Email Address:
Military Service
Have you ever served in the Armed Services? Yes No If “yes”, branch: _________________________
Dates of Service: from / / to /
/ Type of Discharge:
Employment History
Present Employer: Supervisor’s Name:
Supervisor’sPhone:
Work Address: Position Held:
How Long With
Present Employer:
Work Schedule: Shift Len
g
th:
Straight Days
Straight Evenings
Straight Nights
Rotating Shift
8 Hour Shifts
10 Hour Shifts
12 Hour Shifts
24 Hour Shifts
If less than five (5) years with present employer, list previous employer(s)
Employer Name: Address:
Phone: Reason for Leaving:
Employer Name: Address:
Phone: Reason for Leaving:
Employer Name: Address:
Phone: Reason for Leaving:
PFD Application Pa
g
e 2 of 5
PFD Application Pa
g
e 3 of 5
Background Information
Do you have charges pending or have you admitted guilt or been found guilty including Deferred
Adjudication of committing any felony or misdemeanor? (Include offenses for which probation was
granted, excluding minor traffic violations but including DWI.) Yes No
If your answer is “Yes”, explain in the space provided, giving the dates and nature of the offense, the
name and location of the court, and the disposition of the case.
Education
Dates of Attendance Did
y
ou
Institution Name State From Until Graduate?
High School
College
College
College
If you did not graduate from high school, did you attain a GED?
If yes, in what state did you receive your GED ____________________
Yes No
Fire Fighting Experience and Training
Have you previously been a member of one (1) or more Fire Departments or brigades? Yes No
Fire Department / Company
Name
Address
From
Member
Until
Have you attended any fire fighting schools previously? Yes
No
If yes, include copies of any certificates you have received with this application.
PFD Application Pa
g
e 4 of 5
References
Have you applied for membership with the Pasadena Fire Department previously?
Yes
No
Are you now a member of another Fire Department or brigade?
Yes No
List any members of the Pasadena Fire Department with whom you are acquainted.
List three (3) references, other than relatives and any named above:
Name
A
ddress
(
Street, Cit
y
, State, Zip
)
Phone
Emergency Contact Information
Name Phone Relationship
Essay
Why do you want to be a fire fighter (50 to 100 words)?
PFD Application Pa
g
e 5 of 5
Statement of Veracity
Review your answers carefully and read the statement below before signing:
I represent and warrant that the answers I have given are complete and true to the best
of my knowledge and belief.
I further acknowledge that I have read and understood the questions regarding criminal
records and my background, and that I have answered these questions completely and
truthfully.
I understand that failure to answer all questions completely and truthfully will subject
me to dismissal from the Pasadena Volunteer Fire Department Academy or the Pasadena
Volunteer Fire Department.
Applicant’s Signature Date
Should you have any questions concerning this application, please call the Fire Department at
(713) 475-5554, Monday through Friday between the hours of 9:00 AM and 5:00 PM.
Visit our website at https://www.pasadenatx.gov/306/Fire
IMPORTANT !!
Email, or print to deliver or mail this application to the Fire Administration office at
the address below. DO NOT deliver it to a fire station.
PASADENA FIRE DEPARTMENT
Attn: Application
923 Shaw Ave.
Pasadena TX 77506-1519
Checklist of Items to Include With Application
A copy of your driver’s license
A copy of your GED certificate if you did not graduate from High School
Copies of fire service training records and certificates
Please e-mail or print to deliver or mail this application to the Fire Department
Administration office at the address below. DO NOT deliver this application to a fire
station.
PASADENA FIRE DEPAR
TMENT
Attn: Application
923 Shaw Ave.
Pasadena TX 77506-1519
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Pasadena Fire Department (City of Pasadena, Texas)

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Completed 25 February 2021

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