First Name *

Last Name *

What is your date of birth? *

What is the best phone number for us to contact you? (xxx)xxx-xxxx *

What is your address? Street number and name: *

What is your address? City: *

What is your address? State: *

What is your address? Zip Code *

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

Do you have Alabama Fire Firefighter I/II? *

What level of Alabama EMS license do you currently have? *

What is your Alabama EMS license number?

What is your NREMT certification number?

If you are not a Paramedic, are you currently in Paramedic School? *

What is your highest level of education? *

What type of employment are you seeking? *

What shift are you available to work? *

Do you have a CPAT (Candidate Physical Ability Test) certificate? *

Have you ever served as a volunteer firefighter? *

How many years of professional (paid) firefighting experience do you have? *

What certifications do you have from the Alabama Fire College? *

Are you currently or have you ever served in the U.S. Armed Forces? *

Have you ever been convicted of a crime? A criminal background check is performed on all new employees. *

If you answered "yes" to the previous question, please explain.

Qualified candidates that can meet the staffing needs of the Center Point Fire District will be called for a structured interview. The Center Point Fire District maintains a list of interested individuals and it may be some time before you hear from us. If your information changes substantially, you can fill out and submit a new form. All candidates called for an interview will be required to bring documentation validating the qualifications that they have listed. The Center Point Fire District is an equal opportunity employer. Please type your initials below to attest that all of the information that you have entered is accurate. *