Pleasant Hill Goshen Fire & Rescue Volunteer Firefighter Application

PLEASANT HILL GOSHEN FIRE & RESCUE IS AN EQUAL OPPORTUNITY EMPLOYER

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General Information

Position Applying For
Name*
Address*
Do you have a legal right to work in the U.S.?*
All new hires will be required to submit verification of the legal right to work in the United States within three (3) business days beginning with their first day of work. In accordance with the Immigration Reform and Control Act of 1986, we are legally prohibited from employing anyone who cannot provide such verification. The District is not able to accommodate an HB-1 Visa.

Driver's License Information

Do you have a valid driver's license?*
Do you have a valid CDL?*

Education Information

Do you have a high school diploma or GED?*
Have you completed any college or university course work?*
Name of College/University Major Type of Degree Actions
     
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Do you have any professional registrations, licenses, and/or certifications?*
Type of registration, license, and/or certification: License Number (if applicable) Actions
   
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Do you have any specialized training and/or have attended any trade schools?*

Mililtary Service

Are you a Veteran or qualified spouse of a Veteran?*
Max. file size: 256 MB.

Employment History

Begin with your present or most recent employer. List ALL jobs, paid or volunteer, over the last 5 years. Include any experience prior to 5 years ago that relates to the position. To add a new position to the list, click "Add Entry".
Position Title Name of Employer Start Date (Month and Year) Actions
     
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Have you ever been terminated, discharged, or resigned in lieu of termination due to misconduct or unsatisfactory service?*

Professional References

Please add up to 3 professional references.
Name Actions
 
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PLEASE READ THE FOLLOWING STATEMENTS AND CAREFULLY REVIEW YOUR ENTIRE APPLICATION MATERIAL BEFORE SIGNING BELOW.

Eligible Employees and/or Volunteers WILL:
- Be 18 years at the time of conditional offer of employment
- Possess a valid state driver’s license and acceptable driving record by time of conditional offer of employment.
- Have no criminal conviction that would prevent certification from the Oregon Department of Public Safety Standards and Training (DPSST). Mandatory Conviction information can be found at http://www.oregon.gov/dpsst/PS/docs/PSDisquals.2014.pdf
- Successfully pass oral interview process
- Successfully pass an in-depth background investigation
- Successfully complete a medical and drug screening test
- Successfully complete District orientation training
- Successfully complete District approved academy
- Successfully complete physical agility test

Certification of Understanding:
- I also authorize the Pleasant Hill Goshen Fire & Rescue to make all necessary and appropriate investigations allowable by law to verify the information concerning my employment.
- I understand that in consideration for my employment: I agree to comply with all federal, state and local laws, as well as District policies, procedures, rules/regulations, and guidelines, which may be changed from time to time.
- I understand that despite its legality in Oregon the Pleasant Hill Goshen Fire & Rescue maintains a policy in adherence with Federal Guidelines for Marijuana use. I agree to comply with this policy and submit to a drug screen from time to time should one be requested.
- By signing this application, I certify that all statements made on this form are true and complete to the best of my knowledge. I understand that, any omission, misstatement, or falsification may be cause for rejection of this application and/or discharge from Pleasant Hill Goshen Fire & Rescue.
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