Application for Firefighter (Captiva Island Fire Control District logo.) The attached documents can be downloaded and signed as needed. Certain forms will need to be printed, signed, and attached to the online application. Complete New Hire Application.pdfAgreement.pdfAttention.pdfTobacco And Substance Abuse Affidavit.pdfDrug Free Workplace.pdf Please select one or both positions you are applying for: Firefighter EMT Firefighter Paramedic PERSONAL INFORMATION Name (required) Street Address (required) Telephone Number (required) Are you legally eligible for employment in the USA (required) Yes No If hired, give a date you will be available to start work (required) Referred by Have you ever been arrested? Yes No If Yes, please explain Have you ever been charged or convicted? (required) Yes No If Yes, please explain Have you even been demoted, discharged or forced to resign? (required) Yes No If Yes, please explain Are you related to anyone employed by the Captiva Island Fire Control District? (required) Yes No If Yes, give name and relationship Do you have a valid Florida Driver's License? (required) Yes No Driver's License Number (required) Driver's License Expiration Date (required) EDUCATION Highest grade completed (required) Name and Location of High School (required) Name of College or University Attended Number of Years Completed Other Schools Attended (Business, Techincal, etc.) Do you have a valid trade license or certificate? (required) Yes No If Yes, type and expiration date Are you a veteran of the armed forces? (required) EMPLOYMENT HISTORY Employer (required) Employer Address (required) Employer Telephone Number (required) Dates Employed (required) Hourly/Salary Rate (required) Work Performed (required) Job Title (required) Reason for Leaving (required) *** Employer (required) Employer Address (required) Employer Telephone Number (required) Dates Employed (required) Hourly/Salary Rate (required) Work Performed (required) Job Title (required) Reason for Leaving (required) ATTACH ADDITIONAL SHEETS IF NECESSARY Resume Do you have any objection to your current employer being contacted? (required) Yes No Describe any special experience, skills, or qualifications you may have Indicate any foreign languages you speak (required) PERSONAL REFERENCE Give three (3) references (no relatives or fellow employees) who have known you well for the past three years. Complete Name (required) Years Known (required) Telephone Number (required) *** Complete Name (required) Years Known (required) Telephone Number (required) *** Complete Name (required) Years Known (required) Telephone number (required) AGREEMENT STATEMENT Please attach the agreement statement (required) ATTENTION STATEMENT Please attach the attention statement (required) TOBACCO AND SUBSTANCE ABUSE AFFIDAVIT Please attached the signed affidavit (required) DRUG FREE WORKPLACE ACKNOWLEDGEMENT & TESTING CONSENT FORM Please attached the signed acknowledgement and consent form (required) There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
