Fire Department Employment Application

An Equal Opportunity Employer
A person with a disability or handicap requiring accommodation for completing this application process should notify the Personnel Director as soon as possible. The Charter Township of Kalamazoo (Township) is an Equal Opportunity Employer. It is the Township's policy to afford equal employment opportunity regardless of race, religion, color, national origin, sex, age, marital status, height, weight, disability, citizenship, or veteran status. Michigan law requires that a person with a disability or handicap requiring accommodation for employment must notify the employer in writing within 182 days after the need is known.
Personal Information
Name * Required
First Middle Last
Present Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Cell Phone
Home Phone
Position Desired * Required
Salary/Hourly Rate Desired * Required
Date Available * Required
MM slash DD slash YYYY
Are you at least 18 years old? * Required
- Yes
- No
Work Permit No. * Required
Have you previously been employed by the Township? * Required
- Yes
- No
Dates of Employment
Beginning Date End Date
Under what name were you employed?
First Middle Last
Have you submitted an application to the Township before? * Required
- Yes
- No
Date Submitted
MM slash DD slash YYYY
Under what name did you submit the application?
First Middle Last
Please list any/all relatives currently employed at the Township. * Required
Does the position for which you are applying require a driver's license? * Required
- Yes
- No
Driver's License Number * Required
Educational History
Highest Grade Completed * Required
Name of High School * Required
Do you have a GED?
- Yes
- No
State * Required
Schools Attended (other than high school)
Please provide information for all schools or programs you attended after high school, including trade schools.
School #1 Name
School #1 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School #1 Major or Course of Study
School #1 Attendance Dates
Start Date End Date
School #1 Degree Completed
School #2 Name
School #2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School #2 Major or Course of Study
School #2 Attendance Dates
Start Date End Date
School #2 Degree Completed
School #3 Name
School #3 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School #3 Major or Course of Study
School #3 Attendance Dates
Start Date End Date
School #3 Degree Completed
School #4 Name
School #4 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School #4 Major or Course of Study
School #4 Attendance Dates
Start Date End Date
School #4 Degree Completed
School #5 Name
School #5 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School #5 Major or Course of Study
School #5 Attendance Dates
Start Date End Date
School #5 Degree Completed
School #6 Name
School #6 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School #6 Major or Course of Study
School #6 Attendance Dates
Start Date End Date
School #6 Degree Completed
Do you possess any training skills or certifications not asked for on this application? * Required
- Yes
- No
If yes, please explain.
Employment History
List below, beginning with the most recent employment. Please list all present and past employment.
Employer #1
Company Name Job Title/Position Salary/Hourly Wage
Employer #1 Dates of Employment
Start Date End Date
Employer #1 - Supervisor
Name Title
Employer #1 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer #1 Phone Number
Employer #1 Brief Description of Duties
Employer #1 Reason for Leaving
Employer #2
Company Name Job Title/Position Salary/Hourly Wage
Employer #2 Dates of Employment
Start Date End Date
Employer #2 - Supervisor
Name Title
Employer #2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer #2 Phone Number
Employer #2 Brief Description of Duties
Employer #2 Reason for Leaving
Emergency Contact Information
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Relationship
Employment Application Agreement
I certify that all of the information furnished on this Application is true, complete and correct. I understand and agree that any falsification, misrepresentation or omission of fact, either on this Application or during the pre-hire process, will be reason for (1) my not being offered employment, or (2) dismissal at any time from the service of the Charter Township of Kalamazoo (Township), if employed.
I understand that consideration for employment at the Township is conditional upon a review of my qualifications, work history, references, etc. I authorize the Township to request and obtain verification that the information given by me on this Application is true, accurate, and complete. I understand that such verification may include, but may not be limited to background information pertinent to the position for which I have applied, verification of education, verification of employment history, investigation of criminal history, etc. I therefore authorize my current and all previous employers to cooperate with the Township and to release, on a confidential basis, any information they may have concerning me, including information in my personnel record or otherwise known to them, to the Township in connection with my application for employment with the Township. I specifically release from liability any current or former employer(s), its agents, representatives, employees, officers, directors, etc., for or on account of their providing/disclosing such information to the Township.
I understand and agree that my employment and compensation is for no definite period and may, regardless of the time and manner of payment of my wages and salary, be terminated at any time by me or the Township, with or without cause, and/or terminate any policies, practices, procedures, and standards it has adopted or implemented, to the extent, not prohibited by law. I acknowledge that no Township employee nor representative, other than the Township Board, has either the power or authority to enter into any agreement for employment for any specified period of time, or to make any representations or agreements contrary to any of the foregoing, unless that agreement is in writing and is signed by the Township Supervisor. I understand that any prior representations, promises, contracts or statements made by or on behalf of the Township are expressly superseded by the foregoing.
The Immigration Reform and Control Act of 1986 states that employers must require all persons hired to submit documents to the employer showing their identity and their right to be lawfully employed in the United States. It also requires that the employee complete and sign a government form to this effect. I understand that if hired by the Township, I will timely furnish documents for inspection that verify my identity and that I am legally permitted to work in the United States. Furthermore, I understand that my employment will be terminated if I fail to timely provide the necessary documents.
Attachments
Resume
Max. file size: 25 MB.
Cover Letter
Max. file size: 25 MB.
Electronic Signature * Required
First Middle Last

Beginning Date	End Date

Charter Township of Kalamazoo Employment Application Employment Application Fire Dept. Employment Application

An Equal Opportunity Employer

Personal Information

Educational History

Schools Attended (other than high school)

Employment History

Emergency Contact Information

Employment Application Agreement

Attachments