FIREFIGHTER APPLICATION
FULL NAME___________________________________________________________
ADDRESS_____________________________________________________________
BIRTHDATE___________________________________________________________
S.S. #________________________________________________________________
Driver’s License#______________________________________________________
PLACE OF EMPLOYMENT________________________________________________
DAYS AND HOURS YOU WORK WEEKLY, (EXAMPLE: MON-FRI, 7AM-5PM)
WOULD YOU BE ABLE TO LEAVE WORK TO RESPOND TO AN INCIDENT?___________
EVER BEEN A MEMBER OF A FIRE
DEPARTMENT?__________
DESCRIBE ANY SKILLS, OR OTHER QUALIFICATIONS WE SHOULD KNOW.________________________________________________________
UPON REQUEST,
CAN YOU PROVIDE A CONDITION OF PHYSICAL HEALTH?____________
BY
SIGNING BELOW, YOU STATE FACTS ARE TRUE GIVEN, AND YOU GRANT US PERMISSION TO DO A BACKGROUND CHECK .
Note: The
Murfreesboro Fire Rescue is a volunteer department
SIGNATURE DATE
Print application, fill out and mail to Murfreesboro Fire Rescue,p.o. box 251, Murfreesboro, AR. 71958
For more
information contact Fire Chief Alan Walls at (870)-200-1365
