Employment Application

Jarrell Fire Rescue

Williamson County Emergency Services District No.5

212 N 5th St, Jarrell, TX 76537 | (512) 746-2505 | hradmin@wilcoesd5.org

Employment Application Information

Minimum Qualifications
- Texas Commission on Fire Protection Structural Firefighter - Basic (Must be certified by date of job offer)
- Texas Department of State Health Services Emergency Medical Technician - Basic (Must be certified by date of job offer)
- Acceptable criminal record (defined below)
- Acceptable driving record (defined below)
Preferred Qualifications
- NIMS 100, 200, 700, 800
- State of Texas Class B driver’s license
- National Fallen Firefighter Foundation: Courage to Be Safe
- National Highway Traffic Incident Management
- Ability to speak Spanish
- Veterans & prior fire service experience
VETERANS
For applicants that can provide a DD-214, showing a discharge under honorable conditions, five (5) bonus points will be applied to their multi-panel interview.

PRIOR FIRE SERVICE EXPERIENCE
For applicants that can provide written verifiable proof of 5 years full-time “Career” fire experience five (5) bonus points will be applied to their multi-panel interview.

All applications will be reviewed using an Applicant Check Sheet. The following minimum factors will be checked:
- Completed application
- Release of employment records
- Verification of minimum qualifications
  - TCFP certifications
  - TDSHS certifications
Once the application has been received, reviewed, and accepted, a three-part applicant selection process will be scheduled. The applicant selection process includes a physical agility test, multi-panel interview (two panel interviews and one secnario based assesment), and a Fire Chief/Asst. Fire Chief interview.

Part 1: Physical Agility Test

Applicants whose applications are accepted will receive a confirmation email and invitation to the application selection process which begins with the physical agility test. Applicants will be required to sign a release of liability form prior to participating in the physical agility test.

The physical agility test will consist of:
- Charged hose drag;
- Equipment carries;
- Keiser sled;
- Rescue mannequin drag;
- Fixed ladder raise (x2)
The applicant must complete the tasks within a 4-minute timeframe to pass the physical agility test. Applicants will receive a walkthrough of the physical agility test and be given a chance to ask any questions prior to attempting the test. The physical agility test will be graded as PASS or FAIL.

Part 2: Multi-Panel Interview

Applicants who pass the physical agility test will proceed to the multi-panel interview portion of the applicant selection process. Applicants will be informed of the location, date, and time of their multi-panel interview following successful completion of the physical agility test.

The multi-panel interview will be scored using an "Interview Score Sheet". Applicants will participate in two interview panels and one scenario based panel. During each, the applicant will ask and answer questions that the interviewers will interpret and grade on the Interview Score Sheet.

The applicants score across the three panels will be combined to rank all applicants. At this time, prior military service and prior fire service experience points will be added. Applicants will then be ranked highest to lowest. The organization will then invite a number of applicants, based on hiring needs, to the final Chief's Interview portion of the selection process. Selected applicants will receive notice of location, date, and time of their Fire Chief's Interview.

Part 3: Fire Chief's Interview

Based on the hiring needs of the organization, the top applicants will be invited to participate in the final phase of the selection process, the Fire Chief's Interview. The interview will be conducted by the Fire Chief and Assistant Fire Chief who will use the same "Interview Score Sheet" to document and score applicants responses. The final applicants scores will be tallied and then ranked from highest to lowest.

Should an applicant be selected the organization will provide a contingent job offer upon which time the applicants criminal history, driving record, TCFP certifications, TDSHS certification, education documents, prior fire service experience in appliable, and prior military experience if applicable will be verified. Those applicants with contingent job offers will be informed of all necessary steps to achieve employment based on their circumstances.

Scoring Information
- Physical Agility Test: 20% (Pass or Fail)
If the applicant passes they will obtain the maximum of 20 points. If an applicant fails they will receive no points and not be allowed to continue in the process.
- Multi-Panel Interview #1: 20%
The applicant can obtain a maximum of 20 points.
- Multi-Panel Interview #2: 20%
The applicant can obtain a maximum of 20 points.
- Scenario Based Panel: 20%
The applicant can obtain a maximum of 20 points.
- Applicants scores from the (4) previous events will be tallied. Those that meet the criteria above for bonus points will have them added to their tallied scores (max of 5 bonus points).
Based on hiring needs, the top applicants will be invited to participate in the Fire Chief / Asst. Chief Interview.
- Fire Chief / Asst. Chief Interview: 20%
The applicant can obtain a maximum of 20 points. The top applicants, based on the organizations hiring needs, will be awarded contingent job offers and will be informed of all necessary steps to achieve employment based on their circumstances.

Application Instructions and Requirements

Please read all information provided herein:
1. Applications that are improperly completed or incomplete may be rejected and the applicant may not be allowed to proceed in the candidate selection process.
2. All potential applicants must complete a comprehensive application. Completion of the application and acceptance by Williamson County Emergency Services District No.5 is merely the beginning of the process for selection.
3. Applications are only accepted during specified time periods.
4. Each application must be completed exactly as specified in the instructions for the application to be accepted. Applicants must be certified at a minimum by the Texas Commission on Fire Protection as a Structural Firefighter Basic, and by the Texas Department of State Health Services as an Emergency Medical Attendant – Basic by the date of job offer.
The following is a list of absolutes which must be met before and application will be processed:
- All applications must be complete
- Applicants must include detailed explanation of entries on criminal history or driving record
- All blanks must be filled in or have “N/A” entered for not applicable fields
- Applications must be turned in by the application closing date
Applicants that are eligible to take the exam and participate in the selection process will receive notice of the testing date and instructions via email. Applications that are rejected will NOT be notified.

Disqualifications

Criminal History
- Having a conviction for; under indictment for; or, currently charged with any felony offense.
- Previous convictions will be evaluated on a case-by-case basis, but in general the conviction will need to be in excess of 5 years prior
- Having a conviction for; under indictment for; or, currently charged with any Class A or Class B misdemeanor offense on or after a date that is within 3 years of the application closing date for the current selection process.
- Having a conviction for “Driving While Intoxicated/Driving Under the Influence”, (DWI/DUI), on or after a date that is within 3-years of the application closing date for the current selection process.
- Applicants must successfully pass Texas Criminal History Check. A name-based search of the Texas Department of Public Safety database of crimes committed in
  Texas and obtain a fingerprint card. This will be the responsibility of the applicant to pay for. For out of state applicants and FBI fingerprint-based sear of bot the DPS database of crimes committed in Texas and the Federal bureau of Investigation database of crimes committed within the United States. This will be the responsibility of the applicant to pay for.
Driving Record
- Having a record that shows excessive traffic convictions or negligent traffic collisions on or after a date that is within 3-years of the application closing date for the current selection process.
- Having a record that indicates more than two moving violations on or after a date that is within 3-years of the application closing date for the current selection process.
- Having a driver’s license that is suspended for reasons indicating poor driving on or after a date that is within 3-years of the application closing date for the current selection process.
- Must be insurable through the organizations auto insurance provider.
Military
- Having been discharged from the military service with a dishonorable discharge or a general discharge characterized as bad conduct.
Drug Use
- Illegal use of a controlled substance on or after a date that is within 3-years of the application closing date for the current selection process.
- Having any record of illegal and excessive use and possession of controlled substance; or having furnished illegal controlled substance to another individual(s).
Negative Work History
- Work history that shows that the candidate was irresponsible or unreliable in previous work positions.
Employment Application

Jarrell Fire Rescue / Williamson County ESD #5
Name*

First NameMiddle NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are your Home and Mailing address the same?*

YesNo
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Prior Living Addresses (3) Years*
List all places where you lived in the past (3) years above in the format (Street, City, State, Zip) or N/A
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Do you have relatives by blood or marriage employed or otherwise associated with Jarrell Fire Rescue / WCESD #5?*

YesNo
List the name and relationship below:
Are you at least 18 years old?*

YesNo
Birthplace:*
Drivers License State*
Drivers License Number*
Drivers License Class*
Drivers License Restrictions*
List all moving violation within the past (3) years:*
Has your drivers license ever been suspended or revoked?*

YesNo
Explain why your drivers license was suspended or revoked:
Have you been involved in any traffic accidents within the past (3) years?*

YesNo
Explain all the traffic accidents you were involved in within the past (3) years:
Have you ever been convicted of a felony and/or a class A or B misdemeanor?*

YesNo
Explain convicted felony and/or class A or B misdemeanor charges:
Do you have prior military service?*

YesNo
Explain the time period of service:
Name and location of last high school attended:*
Did you graduate high school?*

YesNo
Year Graduated:
Last grade completed if you did not graduate:

891011
Did you obtain a GED?

YesNo
When and where did you obtain the GED:
Business / Trade / Technical School
College or University
Graduate or Professional School
List licenses or certifications qualifying you for the position:*
List any special skills or qualifications:*
List any special tools or equipment your can use:*
Employment Record

Give a record of each position held over the last 10 years. Answer all questions clearly and completely. Give all the requested information, including the actual number of hours worked per week if part-time. Give a full description of duties performed so that proper evaluation can be made. Begin with the current or last position held and work back to your first position.
Job Title*
Business Name:*
From:*
To:*
Business Number*
Please enter a valid phone number.
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name*
Supervisor's Title*
Did you supervise employee's:*

YesNo
Number of employee's supervised:*
Employment type:*

Part-TimeFull-Time
Hours Worked*
Final Salary*
Describe the duties of your position in order of importance:*
Reason for leaving:*
Do you need to add a second employment record?

YesNo
Job Title
Business Name:
From:
To:
Business Number
Please enter a valid phone number.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name
Supervisor's Title
Did you supervise employee's:

YesNo
Number of employee's supervised:
Employment type:

Part-TimeFull-Time
Hours Worked
Final Salary
Describe the duties of your position in order of importance:
Reason for leaving:
Do you need to add a third employment record?

YesNo
Job Title
Business Name:
From:
To:
Business Number
Please enter a valid phone number.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name
Supervisor's Title
Did you supervise employee's:

YesNo
Number of employee's supervised:
Employment type:

Part-TimeFull-Time
Hours Worked
Final Salary
Describe the duties of your position in order of importance:
Reason for leaving:
Do you need to add a fourth employment record?

YesNo
Job Title
Business Name:
From:
To:
Business Number
Please enter a valid phone number.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name
Supervisor's Title
Did you supervise employee's:

YesNo
Number of employee's supervised:
Employment type:

Part-TimeFull-Time
Hours Worked
Final Salary
Describe the duties of your position in order of importance:
Reason for leaving:
Do you need to add a fifth employment record?

YesNo
Job Title
Business Name:
From:
To:
Business Number
Please enter a valid phone number.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name
Supervisor's Title
Did you supervise employee's:

YesNo
Number of employee's supervised:
Employment type:

Part-TimeFull-Time
Hours Worked
Final Salary
Describe the duties of your position in order of importance:
Reason for leaving:
Do you need to add a sixth employment record?

YesNo
Job Title
Business Name:
From:
To:
Business Number
Please enter a valid phone number.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name
Supervisor's Title
Did you supervise employee's:

YesNo
Number of employee's supervised:
Employment type:

Part-TimeFull-Time
Hours Worked
Final Salary
Describe the duties of your position in order of importance:
Reason for leaving:
Do you need to add a seventh employment record?

YesNo
Job Title
Business Name:
From:
To:
Business Number
Please enter a valid phone number.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name
Supervisor's Title
Did you supervise employee's:

YesNo
Number of employee's supervised:
Employment type:

Part-TimeFull-Time
Hours Worked
Final Salary
Describe the duties of your position in order of importance:
Reason for leaving:
Do you need to add a eighth employment record?

YesNo
Job Title
Business Name:
From:
To:
Business Number
Please enter a valid phone number.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor's Name
Supervisor's Title
Did you supervise employee's:

YesNo
Number of employee's supervised:
Employment type:

Part-TimeFull-Time
Hours Worked
Final Salary
Describe the duties of your position in order of importance:
Reason for leaving:
May we contact all your previous employers:*

YesNo
Personal Decleration

In your own words, state your reasons for wanting a position with our organization. Address how such a position fits into your long-range career plan.
Personal Declaration*
References

List four people, including their relationship with you, who know you well enough to provide current information about you. Do not list relatives or your current supervisor. You must include complete addresses and phone numbers.
Reference #1 Name*

First NameLast Name
Relationship*
Years Known*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference #2 Name*

First NameLast Name
Relationship*
Years Known*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference #3 Name*

First NameLast Name
Relationship*
Years Known*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference #4 Name*

First NameLast Name
Relationship*
Years Known*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

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Affidavit
AFFIDAVIT OF EMPLOYMENT APPLICATION
STATE OF TEXAS
COUNTY OF WILLIAMSON

I, {name}, hereby affirm that the following statements are true and accurate to the best of my knowledge:
- I am submitting this affidavit as part of my application for employment with Williamson County ESD #5.
- I declare that all information provided in my employment application, including but not limited to my name, contact information, employment history, education, qualifications, and any other information supplied, is true, accurate, and complete.
- I understand that any false statement, misrepresentation, or omission of facts in my application or during the hiring process may result in the rejection of my application or, if employed, my termination from employment with Williamson County ESD #5.
- I authorize Williamson County ESD #5 to verify any and all information provided in my application, including contacting previous employers, educational institutions, and other references to confirm my qualifications for employment.
- I acknowledge and agree that employment with Williamson County ESD #5 is contingent upon successful completion of required background checks, drug screenings, and any other pre-employment processes as determined by the organization.
- I affirm that I understand the terms of this affidavit and that I have voluntarily executed this document as part of my employment application process with Williamson County ESD #5.
Applicant Name*

First NameMiddle NameLast Name
Application Submission Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Applicant Signature*

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