Volunteer Application Applicant Information Last Name (required) First Name (required) Middle Name Address (required) City (required) Zip Code (required) Email (required) Phone Number (required) Are you 18 years of age? (required) Yes No Work Authorization Are you legally authorized to work in the U.S? (required) Yes No Will you now or in the future require employer sponsorship for a work visa or permit? (required) Yes No If yes, please explain Have you applied here before? Yes No Please list any skills which you feel relate to this position. Criminal History Have you ever been convicted of a felony? Yes No Driver License Information Do you have a valid driver's license? (required) Yes No Availability Do you have any commitments or responsibilities that might prevent you from meeting organization requirements? Yes No If yes, please explain. What hours are you available to respond to emergency calls? Can you be available for the following meetings and training sessions? Monday Evening 6:00 p.m. - 9:00 p.m. Yes No Occasional Saturdays 8:00 a.m. - 12:00 p.m. Yes No Education and Training High School (required) Did you graduate? (required) Yes No College/Trade School Subject/Major Do you have a Firefighter I certification? Yes No Do you have a current EMT certification? Yes No Work History Present Employer (required) Supervisor's Name (required) Address (required) Phone Number (required) Job Title (required) Dates Employed (required) Working Hours (required) May we contact Employer? (required) Yes No Specific Duties (required) Previous Employer Supervisor's Name Address Phone Number Job Title Dates Employed Working Hours May we contact Employer? Yes No Specific Duties Previous Employer Supervisor's Name Address Phone Number Job Title Dates Employed Working Hours May we contact Employer? Yes No Specific Duties Military Service (if applicable) Branch of Service Duty Status Active Veteran Reseve References (Please list 3, not related to you) Reference 1 Name (required) Email (required) Phone Number (required) Company (required) Reference 2 Name (required) Email (required) Phone Number (required) Company (required) Reference 3 Name (required) Email (required) Phone Number (required) Company (required) Volunteer Fire Department Acknowledged Requirements I acknowledge and understand that application to become a Volunteer Firefighter with North Whidbey Fire and Rescue (NWFR) requires the following commitment: 1.Complete the Island County Fire Academy course or an InternationalFire Service Training Association (IFSTA) approved Firefighter Icourse and obtain a Washington State Firefighter I certification withinthe first two (2) years or as courses become available, Tuition paid forby NWFR for Island County Fire Academy. 2.Complete the Island County EMT Academy or a National EmergencyMedical Technician (EMT) course and obtain a Washington State EMT-Bcertification within (2) years of Firefighter I certification or as coursesbecome available. Tuition paid for by NWFR for Island County EMTAcademy. 3.Complete Hazardous Materials Awareness and Operations training andobtain Washington State certification. 4.Attending training as prescribed in the Fire Department Policies and StandardOperating Procedures. 5.Being a firefighter is physically and emotionally challenging job andprovides you with self-respect and self-satisfaction. Firefightingrequires training and demands team effort and respect from eachindividual firefighter in the Department. Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
