Firefighter Application Form

Huron East Fire Department Firefighter Application Form

Full Name

Address

Phone Number

Email Address

Are you legally entitled to work in Canada?

Yes

No

Name and Address of Current Employer

Briefly describe your position

Which Fire Department are you applying to?

Brussels

Grey

Seaforth

Do you or will you be able to get permission to leave work for an emergency response?

Yes

No

What is your availability?

Class of Valid Drivers Licence you currently hold

Are you willing to upgrade to a DZ Licence?

Yes

No

List any Emergency Services Training Certificates or Courses you already have

List Current Community Involvement and Interests

Please list names, addresses and phone numbers of 2 references

Reference 1 - Full Name

Reference 1 - Full Address

Reference 1 - Phone Number

Reference 2 - Full Name

Reference 2 - Full Address

Reference 2 - Phone Number

I affirm and certify that the information given on this application is correct.

Agree

I understand that any falsification of statements, misrepresentation, deliberate omission or concealment of information may be considered for just cause for refusal of this application.

Agree

If selected to be a firefighter with the Huron East Fire Department, I agree to have a physical examination done by a medical doctor and form completed and returned to the Fire Chief.

Agree

Thank you for your interest in the Huron East Fire Department. Only successful applicants will be notified.

Signature of Applicant

Clear

Date

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Firefighter Application Form

Huron East Fire Department Firefighter Application Form