• Application for Employment

    Fire Inspector

  • Personal Information

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  •  - -
    Pick a Date

  • Education Information

  •  

  • Employment History

    List your four (4) previous employers, including any military service. Begin with your current or most recent employer.

  • Employer:
    Address:              
    Telephone:      
    Supervisors Name & Title:    
    Title:   
    Duties:    
    From:   Pick a Date   To   Pick a Date   
             
    Reason for leaving:   

  • Employer:
    Address:              
    Telephone:      
    Supervisors Name & Title:    
    Title:   
    Duties:    
    From:   Pick a Date   To   Pick a Date   
             
    Reason for leaving:   

  • Employer:
    Address:              
    Telephone:      
    Supervisors Name & Title:    
    Title:   
    Duties:    
    From:   Pick a Date   To   Pick a Date   
             
    Reason for leaving:   

  • Employer:
    Address:              
    Telephone:      
    Supervisors Name & Title:    
    Title:   
    Duties:    
    From:   Pick a Date   To   Pick a Date   
             
    Reason for leaving:   

  • References

    Please list a minimum of three (3) adults not related to you and not current employers, who you have known for at least three (3) years. All persons to who you refer will be asked to appraise your character, ability, experience, personality and qualities.

  • Name:   *   *   
    Address:*      *   *   *   
    Home Phone: *
    Cell Phone:          
    Occupation:   *   
    Years Known: *         
    Relationship:   *   

  • Name:   *   *   
    Address:*      *   *   *   
    Home Phone: *
    Cell Phone:          
    Occupation:   *   
    Years Known: *         
    Relationship:   *   

  • Name:   *   *   
    Address:*      *   *   *   
    Home Phone: *
    Cell Phone:          
    Occupation:   *   
    Years Known: *         
    Relationship:   *   

  • Name:         
    Address:               
    Home Phone:
    Cell Phone:          
    Occupation:      
    Years Known:          
    Relationship:      

  • Name:         
    Address:               
    Home Phone:
    Cell Phone:          
    Occupation:      
    Years Known:          
    Relationship:      

  • Name:         
    Address:               
    Home Phone:
    Cell Phone:          
    Occupation:      
    Years Known:          
    Relationship:      

  • Applicant's Statement

  • I hereby certify that there are no willful misrepresentation, or falsifications on this questionnaire or supporting documents and that all of my answers are true and correct to the best of my knowledge and belief.

    It is understood and agreed upon that any misrepresentation or omission by me on this application will be sufficient cause for cancellation of this application and/or separation from this employer's service if I have been employed.

    I give the employer the right to investigate all contacts listed and others to secure information about me and to use the information in the decision making process regarding my request for employment. I further release from liability the employer and its representatives for seeking such information and all other persons or corporations for furnishing such information.

    I understand that neither this document, nor any offer of employment from the employer constitute an employment contract unless a specific document to that effects is executed by the employer and employee in writing.

    By entering my name and date below I verify my acknowledgement of, and agreement to, the above statements.

  • Clear
  •  - -
    Pick a Date

  • It is the express policy of the City of Belvidere to consider all applicants for employment without regard to race, color, religion, gender, age, physical disability, political affiliation or national origin (except where a bona fide occupational qualification exists). 

  • Should be Empty: