Employment Application for the Position of Firefighter

Transcription

1 THE CORPORATION OF THE DISTRICT OF SAANICH SAANICH FIRE DEPARTMENT Employment Application for the Position of Firefighter Please read this document and the recruiting information carefully before completing. This questionnaire must be completed in handwriting by the applicant in as much detail as possible. The completed application is to be returned to: Saanich Fire Administration 760 Vernon Avenue Victoria, BC V8X 2W6 If the question asked is not applicable to you, kindly indicate by N/A. All questions must be completed by the applicant. Where a resume is submitted along with this form and the resume responds to a question in the application, please note on the application see resume. Attach a separate sheet if there is insufficient room for your answer to any question. This information is collected for the administrative and/or operational functions of the District of Saanich as authorized by the Community Charter. This information has been collected, and will be used and maintained, in accordance with the Freedom and Information Protection or Privacy Act. Should you have any questions about the above please contact Saanich s Information and Privacy Team at (250) Full Name: Address: (Surname) (Given Names) Telephone (residence): (business): List any other names used or known by: and reason therefore Are you legally authorized to work in Canada? YES NO (If no, and you are selected for employment, you will be required to submit proof of work authorization issued by Canada Employment and Immigration.

2 -2-2. The District of Saanich takes every precaution to avoid conflict of interest in its employment practices, including favoritism in hiring and employment of relatives who may be in a supervisory/subordinate relationship. Do you have relatives employed here? YES NO Please specify: Name Relationship Department 3. EDUCATION & TRAINING (if attaching resume, do not complete this section) Secondary High NAME/LOCATION DATES ATTENDED COURSE/MAJOR GRADE/DEGREE/ DIPLOMA Technical/Business University Other 4. EMPLOYMENT HISTORY (if attaching resume, do not complete this section) CURRENT: What is your present occupation or trade? Employer & Location: From To PREVIOUS: 1. Employer & Location: From To 2. Employer & Location: From To 3. Employer & Location: From To MAY WE CONTACT YOUR YES NO PRESENT OR LAST EMPLOYER FOR REFERENCE? MAY WE CONTACT YOUR YES NO PREVIOUS EMPLOYERS FOR REFERENCE?

3 -3-5. GENERAL INFORMATION Do you have a valid driver s licence? Number: Class of licence and any restrictions: (note: a requirement to become a firefighter is to hold a valid Class 3 B.C. Drivers Licence with air endorsement. The information above will be verified and a Driver s Licence history will be obtained from the Provincial Motor Vehicle Branch) Have you ever been convicted of an offence under the Criminal Code Of Canada or any other federal statute? If yes give details. Valid Occupational First Aid Level 3 YES NO Valid Medical First Responder Level III YES NO On a separate sheet of paper, list any additional skills or training which you feel will support your application. 6. DOCUMENTS: (Please provide the following documentation:) A Full and Complete Criminal Record Check (from the Police Department serving the area the candidate resides in dated within three months of the competition. Copy of Occupational First Aid level 3 or First Responder Level III Certificate Copy of Educational transcripts Copy of valid Class 3 Driver s License with Air Brake endorsement Driver s Abstract (no more than 6 points in the last 3 years) Copy of all Fire related course certificates 7. MEDICAL HISTORY Firefighting and the associated training is physically demanding. Do you have any medical condition that may restrict you in performing your duties as a Firefighter? If yes, give details Requirements for vision and hearing for our department are: a minimum uncorrected vision of 20/30 in each eye, no symptoms of colour blindness and to have normal hearing ability. Are you willing to have a complete physical examination by a doctor of our choice if you are accepted as a Firefighter and have the results of that examination forwarded to the Saanich Fire Department? YES NO

4 -4-8. REFERENCES Please provide the names, addresses, phone numbers, of not less than three references from current or previous employers. You may also submit personal references in support of your application however, they will not be accepted in place of current or previous employment references. (During a background investigation, some of the people listed may be contacted by members of this department and requested to provide details on your character). 9. In paragraph form, indicate what you think your role as a Firefighter should be. Outline what qualities you feel that you have which you can offer the Saanich Fire Department and the community. In paragraph form, indicate why you wish to become a Firefighter.

5 READ CAREFULLY Engagement as a member of the Saanich Fire Department is contingent upon successfully completing a series of written and physical examinations and interviews, followed by an extensive investigation of your record and references. I hereby certify that the statements contained in this application are true and accurate in every respect and I understand and hereby agree, that any misrepresentation contained herein may render my application or subsequent engagement void and of no effect. I also consent to the Saanich Fire Department obtaining information from references, previous employers or government agencies for the purpose of processing this application. Signature of Applicant Date September 2004