Grand Traverse Metro Fire Department

Grand Traverse Metro Fire Department

Application for Employment
We are an equal opportunity employer and will not unlawfully discriminate on the basis of race, color, sex, religion, national origin, age, marital or veteran status, height, weight, or disability.
Please read carefully before you sign this application.
False statements on this application form shall be considered sufficient cause for termination
Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Applicants must be 18 years of age or older. State of Michigan background check will be performed prior to employment.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Number

Area CodePhone Number
Cell Number*

Area CodePhone Number
Work Number

Area CodePhone Number
Driver's License Number*
Driver's License State*
Driver's License Expiration *

MonthDayYear
Date
A valid driver’s license and a clean driving record (0-4 points) is required for employment.
Are you legally entitled to work in the U.S.?*

YesNo

POSITION
Type of Employment Desired*

Part-TimeFull-Time
Position Desired*
Michigan law requires employers to make accommodations to disabled applicants and employees where the accommodation does not impose an undue hardship on the employer.

Disabled employees and applicants may request an accommodation of their disability by notifying Grand Traverse Metro Emergency Services Authority in writing of the need for accommodation within 182 days of the date the person with a disability knows or should know that an accommodation is needed.

Failure to properly notify Grand Traverse Metro Emergency Services Authority will preclude any claim that the employer failed to accommodate the person with a disability.
Will you be able to perform the duties of the position for which you are applying with, or without accommodation?*

YesNo

EDUCATION AND TRAINING
High School Graduate or General Education Test Passed? Diploma issued?*

YesNoOther

List Below College, Business School, Military, Etc. (Most Recent First)

	School Name	Year Attended	Graduated	Misc Comments
1
2
3
4

Please attach supporting documents for education

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License, Certificate or Registration(s)

	License/Cert/Registration	Year Obtained	Expires	Misc Comments
1
2
3
4

Please attach supporting documents for licenses/certifications/registrations

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Special Skills (List all pertinent skills and equipment that you can operate)

WORK EXPERIENCE

Include voluntary work and military experience
#1*
#2
#3

ADDITIONAL INFORMATION
Have you ever been convicted of a crime; felony or misdemeanor?*

YesNo
If yes, where, when and nature of offense:
State any additional information that you feel may be helpful to us in considering your application:
Please Upload Your Cover Letter / Letter of Interest

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Please Upload Your Resume

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Is Resume Uploaded Above?*

YesNo
How did you hear about us?*

AUTHORIZATION AND UNDERSTANDING

Applications will be kept on file for 1 year after date of application.
Upon the signing of this application, I represent that all of the information now or hereafter given by me in support of my application is true and complete. I authorize you to verify any of the information concerning my employment, education, background check, credit or medical history with the appropriate individuals, companies, institutions or agencies, and I authorize them to release such information as you require, including my prior disciplinary employment record, without any obligation to give me written notice of such disclosure. I also authorize you to release any information requested by any of my prospective or subsequent employers without any obligation to give me written notice of such disclosure hereby release you and them from any liability whatsoever as a result of any such inquiries and disclosures.

I agree that any false information in support of my application may subject me to discharge at any time during the period of my employment. I agree that either party may terminate the employment relationship, with or without cause, at any time, and I further agree that this arrangement may only be altered in writing directed to me personally and signed by the Fire Chief. I agree that I shall be bound by other rules, policies, regulations and terms and conditions of employment of the Grand Traverse Metro Emergency Services Authority as they are from time to time changed.

I agree that any action or suit against the Grand Traverse Metro Emergency Services Authority arising out of my employment or termination of employment, including, but not limited to, claims arising under State or Federal civil rights statutes, must be brought within six months of the event giving rise to the claims or be forever barred. I waive any limitation periods to the contrary.
Signature

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Date

MonthDayYear
Date
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Grand Traverse Metro Fire Department

POSITION

EDUCATION AND TRAINING

WORK EXPERIENCE

ADDITIONAL INFORMATION

AUTHORIZATION AND UNDERSTANDING