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Fairfield Fire
Anyone can apply to join the Fairfield Fire Department.
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Firefighter Application
First Name
Last Name
Email
Contact No
Address
Address Line 1
Address Line 2
City
State
Zip Code
Birth Date
Drivers License Number
Drivers License Type (ie Class A, B, C)
Have you filled out an application before?
Yes
No
Are you currently Employed?
Yes
No
May we contact your employer?
Yes
No
What is your Employer's name and phone number?
Have you ever been convicted of a felony or a civil suit?
Yes
No
If yes, Explain:
Do you have any physical, mental, or medical impairment or disablility that would limit your job performance for that position for which you are applying? (ie confined space, afraid of heights, etc.)
Yes
No
If yes, Explain:
Are you a veteran of the U.S. Military?
Yes
No
Are you able to speak, read, or write in a foreign language?
Yes
No
What language(s)? Please list all that apply
Speak
Fluently
Good
Fair
Not At All
Read
Fluently
Good
Fair
Not At All
Write
Fluently
Good
Fair
Not At All
Can you provide 3 references not related to you?
Yes
No
First Name
Last Name
Reference Phone Number
First Name
Last Name
Reference Phone Number
First Name
Last Name
Reference Phone Number
SKILLS AND QUALIFICATIONS: Summarize special skills and qualifications from employment or other experience:
Applicants must be capable of passing a department paid physical and drug screening. Are you willing to consent to both a physical and drug screening?
Yes
No
Education History: Name of School and Years of Completion:
I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application as may be necessary in arriving at a decision. In the event of acceptance, I understand that false or misleading information give in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all the SOG's and Bi-Laws of the Fairfield Volunteer Fire Department.
Yes
No
Date of Agreement, Signature will be attained in person
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