• Coopersville/Polkton Fire Department Firefighter Application

  • The Coopersville/Polkton Area Fire Department is taking applications for future openings for the position of Firefighter/Medical First Responder (Paid-On-Call). You must have a high school degree or equivalent; be a U.S. citizen or are able to work in the United States; have a valid driver's license with no more than 6 points; have no felony or disqualifying criminal convictions, and be at least 18 years old. Must live in the City of Coopersville or Polkton Township.

  • Personal Information

  •  -
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Have you been previously employed here?*

  • Basic Requirements

  • Are you legally entitled to work in the United States?*
  • Are you 18 years of age or older?*
  • Do you possess a valid Driver’s License and a good driving record?*
  • Have you ever been charged with a misdemeanor or felony?*
  • Do you believe you are free of medical conditions that may preclude your participation as a volunteer firefighter?*

  • Availability

  • Please select your availability for the given days and time.*
  • If hired by the Fire Department, you will be required to attend regular Monday night practices (approximately 7 PM to 9 PM). Can you meet this requirement? *
  • Are you willing and able to participate in the occasional weekend and community events?*

  • Military Service Record

  • Have you had any experience in the Armed Forces of the United States or in a State National Guard?*
  • Are you in the reserves?
  • If yes, date obligation ends:
     - -
    2 digit month, 2 digit day, 4 digit year

  • Skills and Experience

  • Signature:

  • Education
    Rows
  • Employment Experience (list current or most recent jobs first)
    Rows
  • Please indicate if you have any of the following skills or training*

  • References

  • Please provide at three professional references (do not include family members or employers)

  • Terms and Conditions

    By signing below, agree to the terms laid out in the Authorization and Agreement and Authorization of Use of Consumer Reports for Employment Purposes.
  • Authorization and Agreement
  • Authorization of Use of Consumer Reports for Employment Purposes
  • Summary of Your Rights Under the Fai Credit Reporting Act

  • By signing below, agree to the terms laid out in the Authorization and Agreement and Authorization of Use of Consumer Reports for Employment Purposes.
  • Signature*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: