SHERWOOD FD EMPLOYMENT APPLICATION

POSITION APPLIED FOR?

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Today's Date

Date

Driver's License Number & State

How did you hear about this position?

Have you ever been convicted of a felony? (Past criminal history does not necessarily disqualify an applicant from employment.)

yesno

If yes, please describe fully:

Date available for work?

Date

Are you legally eligible for employment in the united States? (If offered employment, you will be required to provide documentation to verify eligibility)

yesno

Are you currently employed?

yesno

May we contact your current employer?

yesno

Do you have any friends and/or relatives employed with Sherwood Fire Department?

yesno

If yes, name and relationship

In case of emergency, who should we contact?

First NameLast Name

Relation

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

High School

From/To

Diploma/Degree

yesno

College

From/To

Diploma/Degree

yesno

College

From/To

Diploma/Degree

yesno

Course/School

From/To

Location

Certificate

Course/School

From/To

Location

Certificate

Course/School

From/To

Location

Certificate

Additional Qualifications (summarize special job-related skills and qualifications)

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Employer

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

From/To

Job Title

Supervisor

Pay Rate/Salary

Were you terminated

yesno

May we contact

yesno

Job duties

Employer

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

From/To

Job Title

Supervisor

Pay Rate/Salary

Were you terminated

yesno

May we contact

yesno

Job duties

Reason for leaving

File Upload

PLEASE UPLOAD RESUME AND CERTIFICATIONS

I certify that the answers given herein, and any attached resume and/or documentation, are true and correct to the best of my knowledge. I understand that any false, misleading or incomplete information furnished by me regarding this application and any attached resume and/or documentation may result in the rejection of this application and, if employed, termination of such employment. I understand and agree that as a condition of my employment I will conform to the Rules and Regulations, Standard Operating Procedures, and Standard Operating Guidelines of the Sherwood Fire Department. I understand and agree that my employment with the Sherwood Fire Department is considered “at-will” and such employment can be terminated with or without cause or notice at any time at the option of the Sherwood Fire Department or myself. I understand and agree to take any physical examination, including drug testing; all such tests will be administered in compliance with the Americans with Disabilities Act. I hereby authorize persons, schools, companies, employers and/or their representatives, to furnish verification to the Sherwood Fire Department any and all information set forth in this application and attached resume and/or documentation. In addition, I agree to hold harmless and release from all liability any and all said persons, schools, companies, employers and/or their representatives, from any and all claims that may arise, including the Sherwood Fire Department, as a result of furnishing such information to the Sherwood Fire Department. I authorize the Sherwood Fire Department, should they employ me, to release employment references if my employment becomes terminated for any reason. I also authorize the Sherwood Fire Department to conduct credit, police, criminal and driving record inquiries, and/or any other employment related inquiries in compliance with the provisions of the Fair Credit Reporting Act, 15 U.S.C Section 1681, et. seq. I understand that the decision for my employment with the Sherwood Fire Department will be subject to the results of these inquiries. I understand this application will be active until this position is filled. After such time, if I wish to be considered for employment, I must re-apply for this position.

Signature

Date

PULASKI COUNTY FIRE PROTECTION DISTRICT #5 DBA: SHERWOOD FIRE DEPARTMENT

EDUCATION

Training/Experience

Personal References

Work Experience

A post-offer of employment drug screen and background check will be conducted on each applicant selected for employment