Volunteer/Employment Application

Equal Opportunity Statement:

Applicants are not required to give any information prohibited by law. Our volunteer policies are nondiscriminatory regarding age, color, sex, race, religion, national origin and disabilities for qualified applicants.

VOLUNTEER POSITIONS

The following are volunteer positions within the department.

Volunteer Firefighter

All applicants not N.C. firefighter 1 certified will be classified as Non-Interior firefighters. A Non-Interior firefighter performs limited service work in fire suppression, hazardous material mitigation, and rescue, and does related work as required. Work is performed under regular supervision. Individuals must excecute orders of their supervisor promptly and efficiently. Applicants N.C. Firefighter 1 certified performs intermedieat protective service work in fire supression. Work is performed under regular supervision. Individual must execute orders of their supervisor promptly and efficiently. No personnel will perform medical care until N.C. Emergency Medical Technician Certified.

Junior Volunteer Firefighter

Performs support functions in fire suppression, and rescue; does related work as required. Work is performed under regular supervision. Individual must execute orders of their supervisor promptly and efficiently.

MINIMUM SELECTION STANDARDS FOR FIREFIGHTER / SUPPORTPERSONNEL
*16 - 18 years of age.

*Enrolled in High School with an overall grade of "C" or better.

*United States citizenship.

*Pass criminal background check.

*Safe driving record (If applicant has driver's license)

Application Directions:

Please fill out this form entirely. Failure to provide all information requested may disqualify you fro the application process. If you have any questions, please call the C.C. Camp Volunteer Fire Department administration at 336-366-2828.

Applicant must obtain and turn in the following documents with this application:

*If applicablle, Copies of fire service certifications, military record, high school diploma or GED

*Signed authorization of background check, pre employment drug testing and disclosure and authorization for a driver's license records check (MVR)

PROBATIONARY PERIOD / RECRUIT TRAINING

Firefighter / Junior Firefighter

Successful firefighter candidates, who are not N.C. Firefighter certified, must attend and complete the N.C. Firefighter certification classes during the recruit-training period (1 Year for non-certified personnel)

Candidates who are N.C. Firefighter certified must attend recruit training at the department and have six months from their start date to complete the training.

Training Requirements:

No previous training or experience is necessary. C.C. Camp Volunteer Fire Department provides all training required of department personnel. All personnel are required to complete a minimum number of training hours annually. The training hours are based on the individuals' position within the department.

Full 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.

Marital Status*

Position Applying for:*

Drug or Food Allergies*

Routine Medications

Social Security Number*

Driver License Number*

State of DL Issue*

Auto Insurance Provider*

Auto Insurance Policy Number*

Emergency Contact Name*

First NameLast Name

Emergency Contact Relation to Applicant*

Emergency Contact Phone*

Please enter a valid phone number.

Emergency Contact Email

example@example.com

U.S. Citizenship Status*

U.S. CitizenNon U.S. Citizen

Employment History*

	Name of Company	City/State	Job Roll	Supervisor
1
2
3
4

Fire/Rescue/EMS Agency History*

	Name of Agency	City/State	Position Held	Supervisor/Commanding Officer
1
2
3
4

Have you ever been forced to resign/terminated from any previous Fire/Rescue/EMS agency? If Yes, Explain.*

Have you Ever Been Convicted of a Felony or Serious Misdemeanor?*

PLEASE READ AND SIGN THE FOLLOWING: I authorize the C.C. Camp Volunteer Fire Department to conduct or hire services to conduct a MVR regarding my drivers license/history. I authorize any parties contacted to release information to my employer or its agent (e.g., a consumer reporting agency) regarding my previous driving record, licenses, certifications, medical inquiries, history and any other information. I release all persons and entities from liability for damages that may arise from the release of this information. I waive all previsions of law prohibiting the disclosure of Information. I understand that the C.C. Camp Volunteer Fire Department and it's agents cannot guarantee the accuracy of any information reported to it by third parties. I release C.C. Camp Volunteer Fire Department and its agents from liability for damages that arise from errors or omissions in this authorized inquiry of my driving history and / or driver's license. Any applicant who refuses to complete this form, omits material facts, or provides false information, will not be considered to operate any apparatus owned and insured by C.C. Camp Volunteer Fire Department.*

AUTHORIZATION FOR BACKGROUND CHECK: I hereby authorize C.C. Camp Volunteer Fire Department Inc. to contact, obtain and verify the accuracy of information contained in this application from all previous employers, educational institutions, references, criminal record, driving record and release any and all persons, companies, or agencies responding to such investigation from any liability for any damage due to releasing information pertaining here to. I understand that any misrepresentation or material omission made by me on the application will be sufficient cause for cancellation of the application or immediate termination of employment, whenever it may be discovered.*

NOTICE TO APPLICANTS REGUARDING PREEMPLOYMENT DRUG TESTING: Any individual applying for a volunteer position with the C.C. Camp Volunteer Fire Department Inc. will be required to submit to a urinalysis drug test as a mandatory part of the application process. This notice serves as a written statement of the department's intention to conduct such testing as part of the application process. The testing will be conducted by a certified laboratory/testing service selected by the department in accordance with the procedures required by applicable state and federal regulations. Tested applicants will be given a copy of any positive test result. All test results shall be considered confidential by the department and shall not be disclosed to the volunteers of the department, or any other person, other than to those persons for whom such disclosure is necessary. Positive test results or a refusal to sign this consent form and participate in pre-employment drug testing shall be grounds for denial of a volunteer/paid position. Arrangements for testing will be made by a representative of the department, in consultation with each applicant. Cooperation in scheduling the testing is important for processing an application. By signing below, you consent to be drug tested and acknowledge you have thoroughly read the foregoing notice, and you understand and agree that in order to be considered for a volunteer position with the C.C. Camp Volunteer Fire Department Inc., you will comply in full with the department's drug testing policy.*

I attest that all information provided is both accurate and truthful to my knowledge and attest that any false information provided may be grounds for termination of application/employment upon finding out during any point during my service.*