Fire Department Application Job application for Walker County Fire Rescue Step 1 of 10 - Basic Information 10% Walker County Government - Fire RescueFire Rescue Employment Guidelines*1. Walker County Government is firmly committed to a policy of Equal Employment Opportunity and does not discriminate against applicants because of race, color, religion, age, national origin, sex, sexual orientation, or disability. 2. Walker County Government maintains a Drug Free Workplace. All job offers are contingent upon the applicant successfully completing a pre-employment drug screen, and all employees will be subject to random drug and alcohol testing as required under the County's Drug and Alcohol policy. 3. Consideration for employment is also contingent upon the results of a reference and background check. If the position requires the ability to drive or operate a motor vehicle, a clear MVR will also be required. 4. If accepted for employment, the applicant shall be required to provide proof of identity and eligibility to work in the United States in compliance with the Immigration Reform & Control Act of 1986. 5. Per the Georgia Smoke Free Air Act 2005, smoking and the use of smokeless tobacco products, as well as vapes and vape products, is prohibited in all enclosed public areas and on County property except as permitted in Code Section 31-12A-6. 6. All information submitted in this application may be subject to public review under the Georgia Open Records Act. 7. This application will be considered active for job vacancies which occur during the next sixty [60] days and held in the Human Resources Department for review by hiring managers. If the applicant wishes to be considered for any positions open after that period, they must renew their application. 8. No applicant will be considered for a position without a current application completed and submitted to the Human Resources Department, Resumes are welcome and may be attached to the application packet but do not, of themselves, constitute an application for a position. 9. All appointments are subject to a (90) ninety day Introductory Period. During this time the employee must demonstrate their fitness for continued employment. 10. No event in the hiring process shall be considered as creating a contractual relationship between the applicant and Walker County Government and unless otherwise provided in writing, such relationship shall be defined as "employment at will" where either party may dissolve the relationship at any time, with or without notice. I understand the application guidelines: Applicant InformationName* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Date Available* MM slash DD slash YYYY Desired Hourly Pay/Salary* Position Applied For:* Days Available to Work:* Select All Sunday Monday Tuesday Wednesday Thursday Friday Saturday Have you ever applied to Walker County Government before?* Yes No If yes, where and when? Have you ever worked for Walker County Government?* Yes No If yes, where and when? Do you currently have relatives who work for Walker County Government?* Yes No If yes, who and where? List all. Are you over 18 years of age?* Yes No Do you have the legal right to work in the U.S.?* Yes No Have you ever been convicted of anything other than a minor traffic offense?* Yes No If yes, explain: EducationHigh School Education*School NameAddressDates AttendedGraduate?Diploma Post-Secondary EducationSchool NameAddressDates AttendedGraduate?Diploma Other EducationSchool NameAddressDates AttendedGraduate?Diploma Please list three professional referencesReferences*NameRelationshipCompanyPhoneAddress References*NameRelationshipCompanyPhoneAddress References*NameRelationshipCompanyPhoneAddress Previous EmploymentResume/Cover Letter Upload Drop files here or Select files Accepted file types: pdf, doc, docx, odf, txt, rtf, Max. file size: 2 GB. Work Experience #1*CompanySupervisorJob TitleStarting Hourly Pay/SalaryEnding Hourly Pay/SalaryReason for Leaving Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Start Date* MM slash DD slash YYYY End Date MM slash DD slash YYYY Leave this blank if you are still working for this employer.Responsibilities*Please briefly describe your role at the company.Why did you leave your last position?* I'm Still Employed Fired Laid Off Seeking Other Opportunities Furthering Education May we contact your previous employer for a reference?* Yes No Additional Experience?* Yes No Work Experience #2CompanySupervisorJob TitleStarting Hourly Pay/SalaryEnding Hourly Pay/SalaryReason for Leaving Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Leave this blank if you are still working for this employer.ResponsibilitiesPlease briefly describe your role at the company.Why did you leave your last position? I'm Still Employed Fired Laid Off Seeking Other Opportunities Furthering Education May we contact this previous employer for a reference? Yes No Additional Experience? Yes No Work Experience #3CompanySupervisorJob TitleStarting Hourly Pay/SalaryEnding Hourly Pay/SalaryReason for Leaving Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Leave this blank if you are still working for this employer.ResponsibilitiesPlease briefly describe your role at the company.Why did you leave your last position? I'm Still Employed Fired Laid Off Seeking Other Opportunities Furthering Education May we contact this previous employer for a reference? Yes No Standard Operating Guidelines (SOGs) Agreement*I hereby agree to abide by all policies, guidelines and procedures of Walker County Fire Rescue during my employment with this department. I also agree to all disciplinary procedures of Walker County Fire Rescue, should I fail to abide by such policies, guidelines and procedures. By clicking the box, I hereby state that I will read and understand the following SOGs prior to employment: #96-17 Uniform Dress and Grooming Code #02-01 Member Misconduct and Disciplinary Action #03-01 Sexual Harassment #03-06 Drug/Alcohol Testing By clicking the box, I acknowledge that I understand.Disclaimer and Signature*I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal at any time during my employment. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release Walker County Government from a/I liability for any damage that may result from utilization of such information. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. By clicking the box, I acknowledge that I understand. Hepatitis B Vaccine (Recombinant)Do you wish to be immunized with Hepatitis B vaccine?* Yes No I have already been vaccinated Whether you wish to be immunized or not, you must fill out the vaccination consent or declination form upon an offer of employment. Background CheckName* First Middle Last Former Name(s) and Dates Used Phone*Current Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current Address Since What Date* MM slash DD slash YYYY Previous Address #1 Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Previous Address #1 Since What Date MM slash DD slash YYYY Previous Address #2 Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Previous Address #2 Since What Date MM slash DD slash YYYY Authorization*I hereby authorize Walker County Government and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports; current and previous residences; employment history; education background; character references; drug testing; civil and criminal history records from any criminal justice agency in any and all federal, state, county jurisdictions; driving records; birth records; and any other public records. I further authorize any individual, company, firm, corporation or public agency to divulge any and all information, verbal or written, pertaining to me, to Walker County Government, or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation or public agency may have, to include information or data received from other sources. Walker County Government and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth. By clicking the box, I am giving my consent.Notice to California, Minnesota & Oklahoma Residents I wish to receive a copy of any Background Check Report on me that is requestedPlease check the box if you wish to receive a copy of a consumer report that is requested. Applicant Affirmative Action ProgramName* First Last Date* MM slash DD slash YYYY Position for which you are applying* To comply with the regulations for Equal Employment Opportunity and Affirmative Action (EEO/AA), Walker County Government (WCG) must track all our applicants by gender, race/ethnicity, veteran status, and the position for which they applied. We are an organization that values diversity and encourages women, minorities, and veterans to apply. For this reason, we invite you to indicate your gender, race/ethnicity, and veteran status below. This information is kept separate from your application. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. Responses will remain confidential within the Human Resources Department and will be used only for the necessary statistical information to include in our Affirmative Action Program and reporting to the government. When reported, data will not identify any specific individuals. I understand the information provided below is voluntaryGenderMaleFemaleRaceHispanic or LatinoWhiteBlack or African AmericanNative Hawaiian of other Pacific IslanderAsianAmerican Indian or Alaska NativeTwo or More RacesChoose not to self-report Veteran Status*This company is also subject to the Vietnam Era· Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires organizations receiving Federal funds to take affirmative action to employ and advance in employment veterans in the following classifications: A "disabled veteran" is one of the following: o a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or o a person who was discharged or released from active duty because of a service-connected disability. A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As an organization subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.I identify as one or more of the classificationsI am not a protected veteran Voluntary Self-Identification of DisabilityWhy are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. If you already work fo us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier. How do you know if you have a disability? You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medication condition.Please check one of the boxes below: Yes, I have a disability (or previously had a disability) No, I don't have a disability I don't wish to answer Disabilities include, but are not limited to: blindness, deafness, cancer, diabetes, epilepsy, autism, cerebral palsy, HIV/AIDS. schizophrenia, muscular dystrophy, bipolar disorder, major depression, multiple sclerosis, missing limbs or partially missing limbs, post traumatic stress disorder, obsessive compulsive disorder, impairments requiring the use of a wheelchair or intellectual disability.Name First Last Today's Date MM slash DD slash YYYY Reasonable Accommodation NoticeFederal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter or using specialized equipment. I understandClick to DOWLOAD this form:Name-based Criminal History Record Information Consent and Inquiry Form. Then fill it out and uploaded up with your application.UPLOAD the name based Criminal History Record Information Consent and Inquiry Form*Max. file size: 2 GB.NameThis field is for validation purposes and should be left unchanged. Δ Share this:TweetRedditPrintEmail