• South Lake County Fire Protection District Member Application

    South Lake County Fire Protection District Member Application

  • The position(s) you are applying for: (check)*
  • Mailing Address same as Physical Address?
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • 1. Are you legally authorized to work in the U.S.?*
  • 2. Are you 18 years of age?*

  • Education and Training

  • Did you graduate?*
  • Did you earn your degree?
  • 6. Have you received Firefighter/E.M.S. training in the past?*
  • Date of Firefighter / E.M.S. Training
     / /
  • 7. Have you received first aid training in the past?*
  • Date last certified
     / /
  • 8. Do you hold current California FF-1 certificate?*
  • Date Certificate Issued
     / /
  • 9. Do you hold current California LEMSA issued EMT card?*
  • Date CA EMT Card Issued
     / /

  • Driving Record Check

  • 10. Do you agree to a driver's license record check?*
  • 10b. Do you have commercial vehicle driving experience?*
  • 10c. Driver's license class?*

  • Availability and Employment History

  • 12. Can you be available for the following meetings and training sessions:
  • 12. Can you be available for the following meetings and training sessions: Third Wednesday of the month for association meeting 6:00 - 9:00 p.m.*
  • Second and Fourth Wednesday drill meetings 7:00 - 10:00 p.m.?*
  • 13. Can you attend our firefighter academy from approximately January to May weekly, on two weekday evenings and some Saturdays?*
  • Format: (000) 000-0000.
  • 14d. Date Employed
     / /
  • 14h. Does business take you out of town
  • 14j. May we contact your employer?
  • 15. Any mechanical, electrical or other specialized work experience?*

  • Military Service

  • References

  • Please list three references that are not related to you.

  • Arrest Record

    Emergency Medical Response training of some levels with the Fire Department requires a Live Scan and a Background Check. Some convictions or occurrences could limit the ability to receive EMS certification. Have you ever, or are you on any of the following that could show up:
  • On or have been on probation of any kind?*
  • Arrested?*
  • Convicted of any crime?*
  • Convicted of any felony?*
  • Been in Jail or Prison?*

  • Volunteer Fire Department Acknowledged Requirements

    I acknowledge and understand that application to become a firefighter with the South Lake County Fire Department requires the following commitment:

    See Association By-Laws

    Selected applicants will be subject to a 12-month probationary period. The following must be completed or accomplished during the 12-month probationary period:

    1. Attend 50 percent of monthly meetings (third Wednesday of each month) and bi-monthly drills (second and fourth Wednesdays
    2. Attend functions of Fire Department and Association events.
    3. Successfully pass company standards, evolutions at training and on the emergency scene.

    There may be additional training required after becoming an active member of the Fire Department.

    1) Being a firefighter is an emotionally challenging job and provides you with self-respect and self-satisfaction. Firefighting requires continuous training and time. Firefighting demands team effort and respect from each individual firefighter in the department. This position requires considerable time commitment. Serious thought and consideration should be given prior to starting the process and training, insuring and outfitting new firefighter(s) is a huge financial commitment on the fire district.

    I have read these requirements and agree to them.

  • Date*
     / /
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