Bennington Fire and Rescue Job Application

Bennington Fire and Rescue always accepts application. Start days may vary but generally are every 3 months. Once you submit your application you will be contacted by someone from our Board of Directors that will explain the rest of the application process.

Full Name *

First Name Middle Initial Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number

E-mail *

Do you have a valid State of Nebraska driver's license?

Yes No

Driver's license #

Expiration Date

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Are you 19 or older

Yes No

Bennington Fire and Rescue requires applicants to be 19 or older by the time they are accepted on to the department.

Do you have any previous Fire or EMS experience

Yes No

If yes, please list previous experience;

Have you ever been convicted of any violation of the law? A conviction will not necessarily disqualify an applicant from the position sought.

Yes No

If Yes, Explain:

Are you a High School Graduate?

Yes No

Are you presently attending school?

Yes No

Field of Study

Do you have a current EMT or Paramedic license?

Yes No

Bennington Fire and Rescue requires all new applicants to obtain a State of Nebraska Emergency Medical Technician license within the their probation period. If you are applying for the out of district program you are required to have this license.

Are you willing to obtain at minimum an EMT license?

Yes No

Provider Level

State Of Nebraska License #

Expiration Date

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Additional EMS Certificates

Healthcare Provider CPR EMS I ACLS PALS PHTLS

Firefighter I

Yes No

Bennington Fire and Rescue requires Firefighter I for all new applicants. You must obtain a Firefighter I certificate during your probation period. If you are applying for the out of district program this certificate is required.

Are you willing to obtain Firefighter I?

Yes No

Additional Firefighter Training

Fire Instructor I Firefighter II Fire Officer I Fire Officer II HazMat Operations HazMat Technician

Current Employer

Job Title:

Phone Number

Area Code Phone Number

Supervisor:

Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Description of Duties:

Inquiry may be made of your current employer or school you are attending.

May we contact your present employer?

Yes No

Do you know or were you referred by a member of Bennington Fire and Rescue

Yes No

Person who referred you:

First Name Last Name

APPLICANT’S STATEMENT AND AUTHORITY TO RELEASE INFORMATION

(Required for ALL Positions)

I understand that this employment application and any other documents are not contracts of employment, and any person hired may be terminated

by the employer at any time for any reason. I understand that any oral or written statements to the contrary are expressly disavowed and should not be

relied upon by a prospective or existing employee. I understand that Bennington Fire and Rescue may modify, change, or revoke any of its employment policies,

pay practices, and benefits without my agreement. I hereby state that all answers on this application are true and understand that falsifying this

information can lead to termination if hired. I UNDERSTAND THAT IN ACCORDANCE WITH Bennington Fire and Rescue POLICY, FINAL CANDIDATES ARE SUBJECT TO

AN ALCOHOL / DRUG TEST AS A CONDITION OF EMPLOYMENT.

I hereby authorize any and all persons, companies, or agencies to release any and all background information, of a confidential or privileged nature,

including criminal history, relevant to this application and any pertinent information they may have to the hiring authorities of Bennington Fire and Rescue. I release

all such parties from all liability of every kind as the result of furnishing the same to Bennington Fire and Rescue. This information is to be used to assist the Fire Department in

determining my qualifications and fitness for the position I am seeking. I hereby release Bennington Fire and Rescue and its officers, agents and employees from any

liability for the use of any and all of the foregoing information, in consideration for being reviewed for the aforesaid position.

Should there be any questions regarding the validity of this release, you may contact me as indicated below.

Type your name in the box below to sign the application.

Full Name *

Date

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Where did you hear this posting?

If other, please tell us where.

Enter the message as it's shown *

Volunteer Firefighter Application

Education:

Professional License or Certificate

Employment History