Application FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth *Address *Phone Number *Email *Driver's License Number. State, and Class *Date Available to Start *Position Apply For *FireighterEMSSupport StaffHigh School Diploma/ GED *YesNoYear of Graduaon/ GED *Highest Level of Education *GEDHighschoolSome CollegeCollege DegreeTechnical InstituteFire/ EMS Experience *YesNoIf yes, list departments/ agencies and years of experience.CPR Certified? Not required upon applying. *YesNoFire Certifications. If none type N/A * to Level Number, EMS Licensure. Not required upon applying *EMREMTAEMTParamedicPHRNNoneIDPH License Number and Expiration. If none, type N/A. *Other Relevant Training. If none type N/A *Current Employer Name. If none, put most recent *Current PositionCurrent Supervisor Name and Phone Number Personal References 1 Name, Phone Number, Relationship *Personal References 2 Name, Phone Number, Relationship *Personal References 3 Name, Phone Number, Relationship *I consent to the Carroll Fire Protection District conducting a background check as a part of the hiring process *YesNoSubmit
