JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
WFD Firefighter / EMT Application
No experience necessary. All training will be provided to selected applicants. Applicants must be 18 years old and no older than 36 at time of appointment. A valid CPAT card will be required at time of appointment.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name (Last, First)
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Street Address
*
Your answer
City, ST, Zip
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
(not required) Currently certified or currently in training for:
Firefighter I/II
EMT-B
EMT-Paramedic
I will provide proof of high school diploma upon request.
*
Yes
No
I will provide a valid Indiana driver's license upon request.
*
Yes
No
I understand that a valid CPAT card will be required prior to offer of employment.
*
Yes
No
By entering my digital signature I swear and affirm that all of the above information is truthful and accurate under penalty of forfeiture from this application process.
Full name (as digital signature)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
