Volunteer Application

Select any/all areas you're interested in (required)

Name (required)

Address (required)

Phone Number (required)

Email (required)

Are you legally authorized to work in the United States (required)

Yes

No

Did you graduate High School? (required)

Diploma

GED

No

What school did you graduate from? Please include the City and State (required)

List your current or last employer (required)

Supervisor's Name and phone number (required)

Job Title of your current/last job? (required)

Briefly describe your job duties (required)

May we contact for a reference? (required)

Yes

No

Reference #1 Please give the name and phone number of a professional or personal reference (required)

Reference #2 Please give the name and phone number of a professional or personal reference (required)

Reference #3 Please give the name and phone number of a professional or personal reference (required)

Please select any current certifications you hold

If your certifications are not from Oregon; What state issued your certifications?

Electronic Signing: By typing my full legal name below, I am certifying that all statements made in this application are true, and I agree and understand that any statement that is false, fraudulent, or misleading in this application or attached material, during the interview or screeninig process, or discovered during any employment-related process (post hire) may result in the revoking of a job offer or termination of employment.

The date you're submitting this application

I certify that all statements contained herein are true and complete. I understand that I must provide proof I am authorized to work in the United States, in accordance with federal law, if I am hired. I authorize the employing agency to verify the employment and education information provided in this employment application. I authorize my driving record to be checked if the position for which I am applying requires driving. I understand and agree to be subjected to a pre-employment drug screening and criminal history background check, if applicable. I am able to perform the essential duties of this position as advertised, with or without reasonable accommodations.

Yes

No

If No, Please explain:

Volunteer Application

Because your time is precious, we have refined our application so the process is as simple & timely as possible. Here are just a couple of quick notes before you fill out this application:

Though our application does not ask for it now. You will be required to provide your Social Security Number in person at your next appointment. Proof of a valid SSN is required to be a fire district volunteer, student, or employee.

We would like to thank you in advance for choosing to become a member of the fire district and being willing to make a difference in Wimer, Rogue River, and possibly beyond. We look forward to you joining our family.

Because your time is precious, we have refined our application so the process is as simple & timely as possible. Here are just a couple of quick notes before you fill out this application:

Though our application does not ask for it now. You will be required to provide your Social Security Number in person at your next appointment. Proof of a valid SSN is required to be a fire district volunteer, student, or employee.

We would like to thank you in advance for choosing to become a member of the fire district and being willing to make a difference in Wimer, Rogue River, and possibly beyond. We look forward to you joining our family.

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