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Volunteer Firefighter Application

  1. El Dorado Fire Department Volunteer Firefighter Application

  2. Circle the appropriate response:

  3. Have you ever failed to pass an insurance physical?
  4. Have you ever filed for Workmen's Compensation
  5. Have you ever been convicted of a felony?
  6. If born after 1959, have you registered with the Selective Service?
  7. Employee Record (Start with the most recent employer.)
  8. Personal References:

    (List two persons you have known for the last 5 years - who you are not related to)

  9. Person to Contact in Case of an Emergency:
  10. Agreement

  11. I certify that the answers given herein are true and complete to the best of my knowledge.

    I authorize the El Dorado Fire Department to investigate all statements contained in this application as may be necessary in arriving at an acceptance decision.

    In the event of acceptance, I understand that false or misleading information given in the application process may result in discharge. I also understand that I am required to abide by all rules, regulations and Standard Operating Guidelines of the El Dorado Fire Department, including the Non-Tobacco Use Policy.

  12. No Tobacco Use Policy

  13. All members of the El Dorado Fire Department are prohibited from using smoking tobacco, in any form, either on-duty or off-duty.  And chewing tobacco on-duty or on city property 

    An employee who violates this policy shall be subject to termination.

    I have read and understand the preceding ‘Tobacco Use Policy’ of the El Dorado Fire Department and agree to its terms.

  14. For Office Use Only
  15. Date Received:                                                                                By:                                                          

     

    Date of Background Check:                                                                                         Completed By:                                                         

    Interview Scheduled For:                                                                                                                                                       Interview Conducted On:                                                                                                                                                                                                    Board Recommendation                                                                                                                                                                       

    Strength & Agility Taken:___________________________________________________________________________________

    Applicant  not  accepted.                              

    Reason:                                                                                                                                                                                                                                                                                                                                                                                                

     


     

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  17. This field is not part of the form submission.