Volunteer Firefighter Application

1
Name* This field is required.
First Name
Last Name
2
Date of Birth* This field is required.Used only for background/driving history checks
Date
Month
Day
Year
3
Cell Phone* This field is required.
Area Code
Phone Number
4
Email* This field is required.
example@example.com
5
Physical Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Indicate your highest level of education* This field is required.
High School Diploma / GED
Associate's Degree
Bachelor's Degree
Master's Degree
Doctoral Degree
7
Are you 18 years of age or older?* This field is required.
8
Are you legally eligible to work in the United States?* This field is required.
9
Are you willing to undergo a medical physical examination conducted by your physician prior to the start of your employment (or provide documentation of an examination dated within the last 12 months)?* This field is required.
10
Are you able to meet the following shift expectations?* This field is required.All part-time positions must submit availability for a minimum of 6 shifts per month. Part-time positions are typically scheduled for 1–3 shifts per week, based on the member's availability, with shifts running from 0600–1500 or 0900–1800, based on departmental needs. RVFD will work with part-time positions to work around full-time job and family schedules.
11
Do you have a valid Texas Driver's License?* This field is required.
12
Driver's License Number (and State, if not Texas)
13
Driver's License Class
(A/B/C - indicate CDL if applicable)
14
Driver's License Expiration Date
(A/B/C - indicate CDL if applicable)
15
Do you maintain valid motor vehicle insurance as required by the state in which your personal vehicle is registered?* This field is required.
16
Are you currently on felony probation, felony deferred adjudication, or parole?* This field is required.
17
Have you ever been convicted, placed on deferred adjudication or community supervision, or pleaded guilty or no contest to a FELONY offense? * This field is required.
18
Have you ever been convicted, placed on deferred adjudication or community supervision, or pleaded guilty or no contest to a Class A or B Misdemeanor offense?* This field is required.
19
If you answered “Yes” to any of the above 3 questions, please explain in detail, with the date, location, nature, and disposition of each offense. You must include any DUI/DWI offenses.
20
Do you understand that as part of the application process, Robinson Volunteer Fire Department will conduct a criminal and driving history check and that any discrepancies may result in disqualification from the application process for a minimum of 12 months?* This field is required.
21
Are you a current member of the Robinson Volunteer Fire Department?* This field is required.
22
Please indicate if you have any of the following current/active certifications.* This field is required.Certificates will be required to submit before official employment offer.
AHA CPR
Texas DSHS EMR / EMT-B / EMT-A / Paramedic
SFFMA Firefighter I
SFFMA Firefighter II
SFFMA Haz-Mat Awareness & Operations
TCFP Basic Structure Firefighter
Driver-Operator Pumper (SFFMA or TCFP)
Driver-Operator Aerial (SFFMA or TCFP)
Texas Class B Driver's License (Exempt or CDL)
Wildland Firefighter
NIMS 100
NIMS 200
NIMS 300
NIMS 400
NIMS 700
NIMS 800
National Traffic Incident Management
Courage To Be Safe
Cancer in the Fire Service Awareness
Fire Inspector I / Basic Inspector
Fire Inspector II / Intermediate Inspector
Fire Inspector III / Advanced Inspector
Fire Inspector IV / Master Inspector
Fire Officer I
Fire Officer II
Fire Officer III
Fire Officer IV
Other
23
Previous/Current Volunteer Firefighter Experience - List Departments & Dates:
24
Previous/Current Paid Firefighter Experience – List Departments & Dates:
25
Previous/Current EMS (Paid & Volunteer) Experience – List Agencies & Dates:
26
Current Employer (List Employer Name, Job Title, and Start Date)
27
Is there anything else you would like us to know while reviewing your application?
28
I certify that all information in this application is true and correct. I understand and agree that any false information, misrepresentation, or concealment of fact is sufficient grounds for my immediate discharge without recourse. I understand and agree that all information in this application may be verified.

I authorize all individuals and organizations named or referenced in this application, or given otherwise by me as references, to give the Robinson Volunteer Fire Department all information about my history, work habits, and character. I authorize the Robinson Volunteer Fire Department to verify and investigate the status of my driver’s license and to conduct any background check it deems necessary, including a review of criminal history records. I release any individuals and organizations contacted, including the Robinson Volunteer Fire Department, Inc.
29
Have you read and affirm that you understand the job description for this position?* This field is required.
30
Date* This field is required.
Date
Month
Day
Year
31
Signature* This field is required.
Should be Empty: