Georgetown Fire Protection District Employment Application

We are an Equal Opportunity Employer and committed to excellence through diversity.

The application must be fully completed to be considered. Please complete each section, even if you attach a resume.
Georgetown FPD Application for Employment
Personal Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number*
e.g. (530) 555-1234
Email address*
example@example.com
Are you legally eligible to work in the US?*

YesNo
Are you a veteran?*

YesNo
If selected for employment, are you willing to submit to a background check?*

YesNo
Position
Position you are applying for*
Available start date*

MonthDayYear
Date
Employment desired*

Full timePart time
Have you attended an Academy?*

YesNo
Location of Academy*
Graduation Date of Academy*

MonthDayYear
Date
Education

List all educational institutions attended*

References (business and professional only)*

Employment History
How many previous employers do you have?*
Employer 1
Employer*
Job title*
Dates employed*

MonthDayYear
Date
Work phone*
e.g. (530) 555-1234
Address*

Address

Street Address Line 2

CityState

Zip
Employer 2
Employer*
Job title*
Dates employed*

MonthDayYear
Date
Work phone*
e.g. (530) 555-1234
Address*

Address

Street Address Line 2

CityState

Zip
Employer 3
Employer*
Job title*
Dates employed*

MonthDayYear
Date
Work phone*
e.g. (530) 555-1234
Address*

Address

Street Address Line 2

CityState

Zip
Employer 4
Employer*
Job Title*
Dates employed*

MonthDayYear
Date
Work phone*
e.g. (530) 555-1234
Address*

Address

Street Address Line 2

CityState

Zip
Employer 5
Employer*
Job title*
Dates employed*

MonthDayYear
Date
Work phone*
e.g. (530) 555-1234
Address*

Address

Street Address Line 2

CityState

Zip
Upload Supporting Documents

provide appropriate documentation
- Cover Letter
- Resume
- CPR Card
- Paramedic License
- Fire Related Certifications
Supporting Documentation
Cancelof
Signature Disclaimer
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my employment being terminated.
Name (please print)*
Signature*

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Date

MonthDayYear
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Personal Information