Required fields are marked with asterisks (*)

Part-Time/Volunteer Firefighter Application

Please note that all applicants will be required to provide a clear police background check (vulnerable persons) AND have a medical practitioner complete a “Pre-Employment Medical Screening” indicating you are fit to perform the duties associated with being a firefighter prior to commencing employment. The necessary forms will be provided if/when placement is offered.

PERSONAL INFORMATION

Confidential When Completed

Last Name

Given Name

Initial

Address

Postal Code

Telephone

Cell Phone

E-mail address

Emergency Contact Name

Emergency Contact Telephone

What is the approximate distance between your residence and the fire station? (55 Hillside Dr N)

0 - 5 KM

6 - 10 KM

10+ KM

What hours would you be available? (Please check all that apply)

Weekdays

Weekends

Weeknights

Other

VOLUNTEER ELIGIBILITY REQUIREMENTS

Are you legally entitled to work in Canada?

Yes

Do you meet the Eligibility Requirements?

I am at least 18 years of age

I live within the City of Elliot Lake

I have a valid Ontario drivers license

I have access to a vehicle

Are you able to understand oral and written English?

Yes

Are you able to understand oral and written French?

Yes

Do you speak and understand other languages?

Yes

Have you ever been convicted of a criminal offence for which you have not received a pardon?

Yes

EMPLOYMENT AND VOLUNTEER EXPERIENCE

Have you ever worked for the City of Elliot Lake previously?

Yes

Present Employer?

Manager/Supervisor's Name

Address

Contact Number

May we contact this employer?

Yes

Please explain your position with this employer, your duties and the length of time employed:

Will your employer permit you to leave work to attend emergencies within The City of Elliot Lake?

Yes

Unsure

Previous Employer?

Manager/Supervisor's Name

Address

Contact Number

May we contact this employer?

Yes

Please explain your position with this employer, your duties and the length of time employed:

Previous Employer?

Manager/Supervisor's Name

Address

Contact Number

May we contact this employer?

Yes

Please explain your position with this employer, your duties and the length of time employed:

Do you have volunteer experience?

Yes

Yes (Only to earn my high school credits)

RELATED SKILLS AND EXPERIENCE

Previous fire fighting or emergency response experience?

Yes

Previous military or police experience?

Yes

Other experiences that may apply to this position?

Yes

OTHER LICENSES AND CERTIFICATION

CPR

Yes

First Aid

Yes

Defibrillation

Yes

Ontario Driver's License

Yes

Do you have additional Certifications, Licenses, or Skills that are relevant to this position? Please explain:

Education Background

Highest grade/level completed:

Have you completed Post-Secondary Education?

Yes

Please note, you may be contacted and asked to provide your resume and copies of any other relevant documents.

Referral

Were you referred by a City of Elliot Lake Firefighter?

Yes

CONDITIONS OF ACCEPTANCE:

I affirm and certify that the information given on, or attached this application is true and correct.

I understand that any falsification of statements, misrepresentation, deliberate omission or concealment of information may be considered just cause for immediate dismissal.

I authorize the City of Elliot Lake Fire Department to contact my references, previous employers or volunteer organizations as indicated and to obtain and review my medical assessment if/when a placement is offered.

I understand I will be required to successfully complete a functional physical fitness test as a condition of employment as a Volunteer Firefighter.

Signature of Applicant

Clear

Personal information is collected in accordance with the Municipal Freedom of Information and Protection of Privacy Act and will be used for Recruitment of Part-Time/Volunteer Firefighters. Questions with respect to the collection and use of this information should be directed to The City of Elliot Lake Fire Department, 55 Hillside Dr N, Elliot Lake, ON P5A 1X5