Volunteer ApplicationApplicant InformationLast Name (required)First Name (required)Middle NameAddress (required)City (required)Zip Code (required)Email (required)Phone Number (required)Are you 18 years of age? (required)YesNoWork AuthorizationAre you legally authorized to work in the U.S? (required)YesNoIf yes, please explainWill you now or in the future require employer sponsorship for a work visa or permit? (required)YesNoHave you applied here before?YesNoPlease list any skills which you feel relate to this position.Criminal HistoryHave you ever been convicted of a felony?YesNoDriver License InformationDo you have a valid driver's license? (required)YesNoAvailabilityDo you have any commitments or responsibilities that might prevent you from meeting organization requirements?YesNoIf 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.YesNoOccasional Saturdays 8:00 a.m. - 12:00 p.m.YesNoEducation and TrainingHigh School (required)Did you graduate? (required)YesNoCollege/Trade SchoolSubject/MajorDo you have a Firefighter I certification?YesNoDo you have a current EMT certification?YesNoWork HistoryPresent 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)YesNoSpecific Duties (required)Previous EmployerSupervisor's NameAddressPhone NumberJob TitleDates EmployedWorking HoursMay we contact Employer?YesNoSpecific DutiesPrevious EmployerSupervisor's NameAddressPhone NumberJob TitleDates EmployedWorking HoursMay we contact Employer?YesNoSpecific DutiesMilitary Service (if applicable)Branch of ServiceDuty StatusActiveVeteranReseveReferences (Please list 3, not related to you)Reference 1Name (required)Email (required)Phone Number (required)Company (required)Reference 2Name (required)Email (required)Phone Number (required)Company (required)Reference 3Name (required)Email (required)Phone Number (required)Company (required)Volunteer Fire Department Acknowledged RequirementsI 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-SignatureReview Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signaturesThere was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.
