Volunteer Benefits

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Church Hill Volunteer Fire Company is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, marital, political affiliation, handicapped status or any other legally protected status.

All questions must be answered. This is an application for a volunteer position and no employment contract is being offered. Volunteer firefighter applicants must be at least 18 years of age.

Name

First

Middle

Last

Social Security Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone Number

Cell Phone Number

List any other name(s) by which you have been known:

Date of Birth

Are you at least 18 years of age?

At this point, please stop and review the job description for which you are applying. After reviewing the essential job functions, the minimum qualifications, and the special requirements from the position description, are you able to do them with or without reasonable accommodation?

Checkboxes

The Fire Department is concerned with your ability to perform the job and will not at this time consider your needs for reasonable accommodation except as necessary to complete the application form. If after reviewing your application form, verifying your responses, conducting an extensive background investigation, conducting necessary interviews or tests, you are considered for the job and would need reasonable accommodation to perform the essential job functions, the parties will explore these alternatives.

WARNING: All information in this application will remain confidential and only released according to law or by signed waiver, however, it will be subject to extensive background examination. Any false, misleading or incomplete statements will be considered grounds for rejection and/or termination. Leave no blank spaces. If the question does not apply to you, mark N/A (not applicable).

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Special Requirements for Volunteer firefighters

Applicants will be subject to an extensive background check. You must provide the Fire Chief (at your expense) a copy of your Motor Vehicle Record which is available from the Maryland Motor Vehicle Administration. Consideration for employment cannot be made until both records have been received by the Fire Chief.
A volunteer firefighter is on probation during his/her first year (12 months) with the fire department.

Applicant: Please Read Carefully Before Signing

I certify that the facts given in this application are true and complete to the best of my knowledge and I agree that information given that is found to be false in any way shall be considered sufficient reason for denial of volunteering for the Church Hill Volunteer Fire Company. I authorize the use of any information in this application to verify my statements and, except as indicated above, I authorize the past employers, all references and any other persons to answer all questions asked concerning my ability, character, reputation and previous education or employment record. I release all such persons from any liability or damages on account of having furnished such information.

I consent to such investigations as the Church Hill Volunteer Fire Company may make regarding driving records, law enforcement records and my general background. I further understand that all applicable portions of this application must be completed or I will be ineligible for consideration for the position for which I am applying.

I understand that nothing contained in this volunteer application or in the granting of an interview or of a position of employment is intended to create an employment contract between the Church Hill Volunteer Fire Company and myself for either employment or for the providing of any benefits. No promises regarding employment have been made to me, and I understand that no promise or guarantee of employment for any specific length of time or under any specified circumstances shall be binding upon the Church Hill Volunteer Fire Company unless made in writing by or with the express written consent and authorization of the Fire Chief. If any employment relationship is established, I understand that I have the right to terminate my employment at any time and for any reason and that the Church Hill Volunteer Fire Company retains the same right.

I understand that, if I am initially offered a volunteer position, the Church Hill Volunteer Fire Company may require me to be subjected to a pre-employment physical and/or drug screen prior to commencement of the volunteer assignment. Refusal to submit to a drug screen shall be considered sufficient reason for denial of the volunteer assignment or discharge.

I understand that if accepted as a volunteer, I agree to abide by the policies and rules issued by the Church Hill Volunteer Fire Company and the Church Hill Volunteer Fire Company may revise policies or procedures, in whole or in part, unilaterally at any time.

Date

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