Application

Date*

MonthDayYear
Date
Position Applying For (Must be 18 or older for paid positions.)*

Full-TimePart-TimeVolunteer FirefighterVolunteer Support
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Driver's License #*
Driver's License Issuing State*
Do you have a social media account? (Facebook, Instagram, YouTube, Snapchat, Tiktok, etc.)*

YesNoYes, but it is set to private
Date of Birth*

MonthDayYear
Date
If you are under 18 years of age, can you provide required proof of work eligibility?*

YesNoN/A
Have you ever been employed with the City of London before?*

YesNo
Are you currently employed?*

YesNo
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status? (Proof of citizenship or immigration status will be required upon employment.)

YesNo
Date available to start?*

MonthDayYear
Date
Are you in a "lay-off" status and subject to recall?*

YesNo
Can you travel if required?*

YesNo
Are you a Veteran?*

YesNo
Are you a First Responder?*

YesNo
Firefighter Number
EMT/Paramedic Number
Comments on any items above
Education/Training

Provide education from most recent to oldest*

Do you have a current CPAT? (CPAT is considered current for one year, or with continued full-time firefighter employment. It is required for full-time firefighters.)

YesNoNo, but scheduled before start date
Special Training, Skills, Certifications or Activities
Comments on Education/Training

References*

Comments on References:
Employment History

Begin with your present to last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.

Comments on Employment History
Upload a Resume

Cancelof
Signature*

Clear
Applicant's Statement: I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge the Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.
Should be Empty:

Education/Training