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FIREHIRE Application

FIREHIRE APPLICATION

All applicants are considered for employment testing without regard to race, color, religion, sex, national origin, age, marital status, veteran status, sexual orientation, or the presence of a non-job related medical condition or disability.

FIREHIRE® LLC is an equal opportunity/affirmative action recruitment registry.

Required fields are indicated by (*).

First Name(*)

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Middle Name

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Last Name(*)

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Date of Birth(*)

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mm/dd/yyyy

Email(*)

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Street Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Telephone(*)

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FIRE SERVICE EXPERIENCE

Are you a certified "Firefighter I"?

YesNoInvalid Input

Did you graduate from a Firefighter I Academy?

YesNoInvalid Input

Is your Firefighter I certification from California?

YesNoInvalid Input

Select yes if you obtained your Firefighter I certification in California, from the California State Fire Marshal's Office.

How many complete years have you worked as a VOLUNTEER FIREFIGHTER?(*)

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How many complete fire seasons have you worked as a SEASONAL FIREFIGHTER?(*)

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How many complete years have you worked as a PAID-CALL FIREFIGHTER?(*)

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How many complete years have you worked as a PROFESSIONAL (PAID) FIREFIGHTER?(*)

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EQUAL EMPLOYMENT OPPORTUNITY DATA

FIREHIRE LLC requests the following information to comply with federal equal opportunity requirements. Information is kept confidential and is used for statistical purposes only. this information is voluntary. Applicants are not required to complete this section.

Are you?

MaleFemaleDecline to stateInvalid Input

Ethnic Origin

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EMPLOYMENT HISTORY

Please list your employment history for the past five (5) years starting with your most recent or current employer:

Employer #1

Employer

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The name of your employer.

Employer's Telephone

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Address

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Your employer's mailing address.

The date you began working for this employer.

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mm/dd/yyyy

Are you currently employed here?

YesNoInvalid Input

Job Title

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Supervisor's Name

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Employer #2

Employer

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The name of your employer.

Employer's Telephone

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Address

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Your employer's mailing address.

The date you began working for this employer.

Invalid Input

mm/dd/yyyy

Are you currently employed here?

YesNoInvalid Input

Job Title

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Supervisor's Name

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Employer #3

Employer

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The name of your employer.

Employer's Telephone

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Address

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Your employer's mailing address.

The date you began working for this employer.

Invalid Input

mm/dd/yyyy

Are you currently employed here?

YesNoInvalid Input

Job Title

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Supervisor's Name

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EDUCATION HISTORY

Please list your education history starting with the last school attended (most recent):

Highest level of education obtained?(*)

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School #1

School Name

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Starting date of attendance: mm/dd/yyyy

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Ending date of attendance: mm/dd/yyyy

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Mailing address

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Did you graduate from this school?

YesNoCurrently EnrolledInvalid Input

Number of units completed

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Degree obtained

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School #2

School Name

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Starting date of attendance: mm/dd/yyyy

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Ending date of attendance: mm/dd/yyyy

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Mailing address

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Did you graduate from this school?

YesNoCurrently EnrolledInvalid Input

Number of units completed

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Degree obtained

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School #3

School Name

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Starting date of attendance: mm/dd/yyyy

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Ending date of attendance: mm/dd/yyyy

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Mailing address

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Did you graduate from this school?

YesNoCurrently EnrolledInvalid Input

Number of units completed

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Degree obtained

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PERSONAL REFERENCES

All FIREHIRE applicants must list three personal references below. The references MUST NOT BE RELATIVES! The references can be friends, previous employers, or anyone who knows and is willing to speak to potential employers about your personal traits and personality. The references will be investigated, so please complete all requested fields.

Any reference that cannot be verified may be grounds for disqualification from the testing process.

Personal Reference #1

Personal Reference: Full Name(*)

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Mailing Address(*)

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Telephone(*)

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How do you know this reference?(*)

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How long have you known this reference, in years?(*)

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Personal Reference #2

Personal Reference: Full Name(*)

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Mailing Address(*)

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Telephone(*)

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How do you know this reference?(*)

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How long have you known this reference, in years?(*)

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Personal Reference #3

Personal Reference: Full Name(*)

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Mailing Address(*)

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Telephone(*)

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How do you know this reference?(*)

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How long have you known this reference, in years?(*)

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SIGN AND SUBMIT APPLICATION

Your signature(*)

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Type your full name as your signature. Your signature indicates that the submission of the data contained in this form is true and correct, and that the undersigned is the same person submitting the information.

Enter the text shown below.

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Submit your application to FIREHIRE