Fire Prevention Application
Please use this form to submit an application for admission into the 2026 fall cohort for the Fire Prevention Program.

You must be an admitted student prior to application. If you have not applied for admission to Chemeketa Community College yet, please visit: https://www.chemeketa.edu/admission/

APPLICATION SELECTION PROCESS
 • Applicants who submit accurate and complete applications by the application close date will qualify for the selection process. (Late applications may be considered only if the program has not been filled.)
 • Interviews will be conducted with selected applicants based on their application materials. Selected applicants will receive further interview details via their my.chemeketa.edu email address. 
• Students will be selected for the program based on their interview performance and application material. After the selection process is completed each month, applicants will be notified of their status—admitted to the program, placed on alternate status, or not admitted—via email or phone. 

• Once the program reaches the maximum number of students for the academic year, any remaining qualified applicants will be placed on an alternate list and contacted if spots become available in the cohort. 

IMPORTANT DATES:
Last Day to Submit Application: August 31, 2026
Fall classes begin: September 28, 2026 

Interview Dates for Selected Students (interviews are 'in-person' at the Brooks Center): 
Application Submitted by:  7/31/26                 Interview Date: August 31, 2026 (Close Date)                                                       8/31/26                 Interview Date: September 10, 2026 

Please note that all communications in this process will be communicated through my student email (@my.chemeketa.edu). 


Email *
Last Name *
First Name *
Preferred name (if applicable)
Date of birth *
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Your K# (A K# is a number the college assigns to you when you are admitted to Chemeketa) *
Your Chemeketa Email (A My Chemeketa email address is a specific Chemeketa email address that is provided to each student when they are admitted to Chemeketa) *
Primary phone number *
I am applying for admission to: *
Emergency Contact Name *
Emergency Contact Phone *
Emergency Contact Relationship *
How did you hear about the Fire Prevention Program? *
In a paragraph, please describe why you are interested in this career path and the Fire Prevention program. *
Check All *
Required
Check All *
Required
The Fire Program requires students to purchase and wear uniforms. Policy prohibits the wearing of non-uniform clothing and most jewelry, including piercings, while participating in cooperative work experience (CWE) and some classes. *
Have you been convicted of a crime? *
If you replied 'yes' to the question above, please provide a detailed explanation.

AFFIDAVIT

By typing my name below, I hereby affirm that all information provided in my application to the Chemeketa Community College Fire Prevention Program is true, complete, and accurate to the best of my knowledge. I understand that any false, misleading, or omitted information may result in denial of admission, dismissal from the program, or other administrative action.

I authorize Chemeketa to make any and all necessary and appropriate investigations to verify information given by me and to examine my fitness for participation in the program. I understand that these investigations will include:

Criminal Background Check

Drug Screen

I further affirm that I understand the physical, academic and ethical standards required for participation in the fire program and that I am able to meet these standards or will disclose any limitations that may affect my ability to do so.

I make this affidavit voluntarily and understand it is a legally binding statement.

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