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Fire Department Application
Fire Department Application
Please enable JavaScript in your browser to complete this form.
CURRENT INFORMATION
-
Step
1
of 7
Position Applying For
Firefighter
When will you be available for employment?
*
What type of employment are you seeking?
*
Part-Time
Volunteer
Name
*
First
Last
Address
*
Address Line 1
Address Line 2
City
North Carolina
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
Phone Number
*
Are you 18 years or older?
*
Yes
No
If no, what is your birth date?
NEXT
Apart from absences for religious observances, select conditions you are willing to accept:
*
Occasional night work
Occasional weekend work
Occasional overtime
Occasional rotating shifts
Occasional on-call
Regular night work
Regular weekend work
Regular overtime
Regular rotating shifts
Regular on-call
Frequent night work
Frequent weekend work
Frequent overtime
Frequent rotating shifts
Frequent on-call
Have you ever been employed with the City of Bessemer City?
*
Yes
No
If so, which department?
Have you ever applied for a position with the City of Bessemer City?
*
No
Yes
If so, indicate the position and when you applied.
Are you willing to accept the salary/wage within the advertised range?
*
Yes
No
Third Choice
Are you now or were you previously related in any way to a City employee?
*
No
Yes
If yes, give the name, relationship, and department.
Are you able to perform all duties of the job you have applied for?
*
Yes
No
Have you ever been convicted of a felony?
*
No
Yes
Third Choice
If yes, please explain. Note- a conviction record WILL NOT necessarily exclude you from employment. Factors such as age at time of offense, rehabilitation efforts, length of time since the offense, and nature of the crime will be taken into consideration.
Are you an American Citizen or do you currently have authorization to work in the U.S.?
*
Yes
No
Did you receive any of your education or employment experience under another name?
*
No
Yes
If yes, please explain:
Next
Indicate the highest school year completed:
*
8
9
10
11
12
13
14
15
16
17
18
18 or more
What is the name of the high school you attended? Please include the City and State of the school.
*
Have you received your high school diploma or equivalent?
*
Yes
No
Please indicate any colleges or universities you attended. Please include: 1) Name and Location, 2) Attendance (month and year started, month and year completed), 3) Did you graduate?, 4) Credit Hours, 5) Name of Your Degree, Diploma, Certificate Earned, Etc., 6) Major and Minor
Please indicate any graduate or professional schools you attended. Please include: 1) Name and Location, 2) Attendance (month and year started, month and year completed), 3) Did you graduate?, 4) Credit Hours, 5) Name of Your Degree, Diploma, Certificate Earned, Etc., 6) Major and Minor
Please indicate any technical institutes or internships you attended. Please include: 1) Name and Location, 2) Attendance (month and year started, month and year completed), 3) Did you graduate?, 4) Credit Hours, 5) Name of Your Degree, Diploma, Certificate Earned, Etc., 6) Major and Minor
Next
Please list any knowledge, skills, or abilities you have that you feel are applicable to the position for which you are applying. Include skills with equipment, machinery, software, etc. you can operate.
*
Next
Please list all registrations, licenses, or certifications you have. Please list the: 1) type, 2) State issued, 3) document number, and 4) expiration date
Please list your valid driver's license number and the state in which it was issued. If youdo not have a driver's license, please put "none" below.
*
Is your driver's license a Commercial Driver's License?
*
No
Yes
If yes, indicate the class below:
Next
Please record your work history below (past 3-5 positions, if applicable). Please indicate the following for each job: 1) Job Title, 2) Starting Salary, 3) Last Salary, 4) Date Employed, 5) Date Separated, 6) Employer or Company, 7) Employer or Company Address, 8) Name and Title of most current supervisor, 9) Length of employment, 10) Duties in order of importance, 11) reason for leaving or desiring a change
*
Have you had disciplinary action taken against you in the past 12 months?
*
No
Yes
If yes, please explain (a "yes" does not automatically disqualify you)
Have you ever been dismissed or forced to resign from any job held?
*
No
Yes
If yes, please explain (a "yes" does not automatically disqualify you)
May we contact your present employer for reference prior to an interview (if granted)?
*
Yes
No
Currently not employed
Please upload your resume and/or cover letter
Click or drag files to this area to upload.
You can upload up to 2 files.
CERTIFICATION AND RELEASE- To the best of my knowledge and belief, the information given truly represents my background and experience. I understand that if I have knowingly or negligently misrepresented, falsified or omitted any information during the application process, or have made any changes to the format or wording of this application form, I may be disqualified for employment consideration or dismissed from employment with the City. I authorize my current and former employers to give any information regarding me or my employment, whether or not it is on their records. I hereby release them from any damage whatsoever for issuing same. I also authorize educational institutions which I attended to reveal my scholastic ratings, as well as degrees or certificates earned, to the City of Bessemer City; and associations, registration and licensing boards and to others to furnish whatever detail is available concerning my qualifications. Notwithstanding any provision of State or Federal law, I expressly waive any right I have to review information the City receives from an employer or educational institution under a promise of confidentiality. I also permit the City of Bessemer City to conduct a Police, Court, Credit and/or Motor Vehicle Records Investigation of my background where related to the job for which I am applying. I understand that if I apply or have applied for certain jobs, I may be tested for drug and alcohol use to determine if I am currently using or abusing these substances. I consent to the testing and understand that the results could preclude my appointment. I understand and acknowledge that should I be employed by the City of Bessemer City, then I serve "at will". This means that I may be terminated at any time. I further understand that this "at will" employment relationship may not be changed by any written document unless such change is specifically approved by the City Manager
*
Agree
Next
The City of Bessemer City is an Equal Opportunity Employer. Please complete this form in order for us to comply with the reporting requirements of the Equal Employment Opportunity Commission. This form will be separate from your employment application. Other than the information you provide in Section I, the information on this form will not be used in any way in our selection process or for any personnel action following employment. It will be maintained in personnel files which must be kept confidential under State law. Public disclosure of this information without your consent would be a violation of state general statutes.
I understand
What is your gender?
Male
Female
Other
What is your ethnicity?
White
Black
Hispanic
Asian or Pacific Islander
American Indian or Alaskan Native
How did you learn about this opening?
Internet
Newspaper
Word of Mouth
Other Print Material
DRUG SCREENING All FINAL applicants for high risk or safety sensitive positions (HRSS) must pass a drug screening process. Further information will be provided at the appropriate time in the employment process.
I understand
OVERTIME COMPENSATION AGREEMENT For employees subject to the overtime provisions of the Fair Labor Standards Act (FLSA), we generally allow the employee to choose between time off or pay for overtime worked. However, either is subject to supervisory approval and may be affected by budgetary constraints.
I understand
SELECTIVE SERVICE REGISTRATION- If male and age 18-26, have you registered for Selective Service?
Yes
No
N/A
CERTIFICATION- I certify that I have read and understand the information contained in this form, complied with the instructions provided, and have done so truthfully to the best of my knowledge.
I agree
Message
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