HARVARD FIRE PROTECTION DISTRICT

Employment Application
The Harvard Fire Protection District is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, national origin, sexual orientation, age, disability or any other category protected by state or federal law. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job related factors. Answer each question fully and accurately. No action can be taken on this application until you have answered all questions.

APPLICANT INFORMATION

EDUCATION

REFERENCES

Please list three Professional references.

PREVIOUS EMPLOYMENT

FIREFIGHTER / EMS CERTIFICATION OR LICENSE

COMPLETE ALL THAT ARE APPLICABLE
(Please list where and when you received your License/Certificates)

SPECIAL SKILLS AND INTERESTS

MILITARY SERVICE


AFFIDAVIT
PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I certify that all of the information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employer and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such person and organizations that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.
I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physician examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.
I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre-employment drug screen as a condition of employment. If required.
I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINATE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERNINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.

HARVARD FIRE PROTECTION DISTRICT

Employment Application
The Harvard Fire Protection District is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, national origin, sexual orientation, age, disability or any other category protected by state or federal law. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job related factors. Answer each question fully and accurately. No action can be taken on this application until you have answered all questions.

Job Application

Applicant Information

Education

References

Previous Employment

Firefighting And EMS Training

CPR

CPR Inst

FFII or III

1st Respond

EMT Basic

Paramedic

Any Other Applicable Certification

SPECIAL SKILLS AND INTERESTS

Military Service

Disclaimer

AFFIDAVIT
PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING
I certify that all of the information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employer and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such person and organizations that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.
I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physician examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.
I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre-employment drug screen as a condition of employment. If required.
I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINATE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERNINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.

 

HARVARD FIRE PROTECTION DISTRICT

Employment Application
The Harvard Fire Protection District is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, national origin, sexual orientation, age, disability or any other category protected by state or federal law. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job related factors. Answer each question fully and accurately. No action can be taken on this application until you have answered all questions.

Job Application

Applicant Information

Education

References

Previous Employment

Firefighting And EMS Training

CPR

CPR Inst

FFII or III

1st Respond

EMT Basic

Paramedic

Any Other Applicable Certification

SPECIAL SKILLS AND INTERESTS

Military Service

Disclaimer

AFFIDAVIT
PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING
I certify that all of the information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employer and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such person and organizations that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.
I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physician examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.
I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre-employment drug screen as a condition of employment. If required.
I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINATE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERNINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.

HARVARD FIRE PROTECTION DISTRICT

Employment Application
The Harvard Fire Protection District is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, national origin, sexual orientation, age, disability or any other category protected by state or federal law. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job related factors. Answer each question fully and accurately. No action can be taken on this application until you have answered all questions.

Job Application

Applicant Information

Education

References

Previous Employment

Firefighting And EMS Training

CPR

CPR Inst

FFII or III

1st Respond

EMT Basic

Paramedic

Any Other Applicable Certification

SPECIAL SKILLS AND INTERESTS

Military Service

Disclaimer

AFFIDAVIT
PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING
I certify that all of the information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employer and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such person and organizations that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.
I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physician examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.
I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre-employment drug screen as a condition of employment. If required.
I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINATE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERNINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.