Careers

Employment/Volunteer Application

Applicant Information

Name *

First

Last *

Last

Mobile Phone *

Email *

Address *

Address

City

State/Province

Zip/Postal

Country

Employment Position Information

Employment Desired *

Position applying for: *

If hired, on what date can you start? *

If needed, are you available to work overtime? *

Yes

Please list current certifications (FF, EMT, AEMT, Paramedic): *

Personal Information

Are you a U.S. citizen or approved to work in the United States? *

Yes

Will you consent to a mandatory controlled substance test? *

Yes

Have you ever been convicted of a criminal offense (felony or misdemeanor)? *

Yes

Please state the nature of the crime(s), when and where convicted and disposition of the case(s).

Background Check

Do we have your permission to perform a background check? *

Yes

Driving Record

Do we have your permission to perform a driving record check? *

Yes

Social Security Number

Drivers License Number and State

Do you have any conditions which would require job accommodations? *

Yes

Note: HCESD #2 / Lumberton Fire & EMS complies with ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.

If yes, please explain required accommodations.

Education and Skills

Military History

Are you a member of the Armed Services? *

Yes

In what branch did you enlist?

Rank when discharged:

Years Served

Discharge Status

Employment History

Employer name *

Employer phone *

Job Title *

Supervisor name *

Dates employed *

Reason for leaving *

Employer name *

Employer phone *

Job Title *

Supervisor name *

Dates employed *

Reason for leaving *

Employer name *

Employer phone *

Job Title *

Supervisor name *

Dates employed *

Reason for leaving *

References

First and Last Name *

Phone *

First and Last Name *

Phone *

First and Last Name *

Phone *

Do we have your permission to check your references? *

Yes

Resume

Maximum upload size: 516MB

If you are human, leave this field blank.