MFD job application

  • Maryville Fire Department Employment Application

    Please complete the form below to apply for a position with us.
  • Which position are you applying for?*
  •  -
  • I certify that I am at least 18 years of age.*

  • Education

  • Diploma received?*
  • GED obtained?*
  • Diploma received?*
  • Graduated?*
  • Graduated?*

  • Job Interest

  • If hired, can you furnish proof you are eligible to work in the U.S.? *
  • Do you have any firefighting experience and/ or Illinois OSFM firefighting certifications?*
  • Are you a licensed EMT or Paramedic in the State of Illinois?*
  • As an EMS provider, are you approved to work in the Anderson Hospital EMS System?*
  • Do you have a valid driver's license?*
  • Expiration date?*
     - -
  • Have you ever driven an emergency vehicle?*
  • Has your driver's license every been suspended or revoked?*

  • Employment History

  • Start date:*
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  • For firefighters, are you willing to undergo a medical physical assessment? EMS providers select N/A.*
  • Do you know anyone who works for the Maryville Fire Department?*

  • Please read carefully and sign

  • I hereby certify that to the best of my knowledge and belief, the answers given by me to the foregoing questions and all statements made by me in this application are correct. I understand that any misrepresentation or omission will be grounds for termination of employment whenever discovered. If employed, I agree that I will not disclose, use or reveal any confidential information related to Maryville Fire Department, or any patient of Maryville Fire Department without first obtaining written consent from an officer of the company. I hereby apply for employment-at-will, on the basis and understanding that I may resign or that such employment may be terminated at any time upon notice given to me personally or sent to my last known address. I consent that you, the employer, or it's agents may verify both personal and job related information that is relevant to the consideration of this application for employment, and fully release Maryville Fire Department from any liability resulting from this process. Neither this application nor any personnel form constitutes an employment contract. I understand that I will not be considered for employment until I have submitted copies of all required licensure, possibly including a copy of my GED or high school diploma.

  • Date submitted:*
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  • Should be Empty: