Jefferson Township Fire Department Employment Application
All applicants are considered for positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

JEFFERSON TOWNSHIP IS AN EQUAL OPPORTUNITY EMPLOYER.

APPLICANT’S STATEMENT
1. I certify that the facts contained in this application are true and complete to the best of my knowledge. I hereby authorize you to conduct a thorough investigation of all statements, written and oral, made by me during the employment application process. I release all parties from any liability in connection with the provision and use of such information.

2. I understand and agree that my falsification, misrepresentation, or omission either on the employment application form or in my responses to questions asked during the interview or examination process may disqualify me from further consideration for employment, or if employed will subject me to immediate termination whenever the falsification, misrepresentation or omission is discovered. In this regard, where an item is left blank on the employment application it is because there is no information within its scope.

3. I understand and agree that, if employed by this organization, I will abide by its rule and regulations which I understand are subject to change.

4. I understand that a physical examination and a chemical test for the presence of illegal and controlled substances may be required before the commencement of any/or during my employment. I release Jefferson Township Fire Department, their authorized agents, their employees, and all other persons, companies, and other entities from any and all liability arising out of any physical examination or chemical testing or for the taking of any action based on the results of any physical or chemical testing.

5. I understand that there is a twelve (12) month probationary period and I may be Probationary Released for any reason. I further understand after the probationary period has ended an At Will Position.

INVESTIGATION AUTHORIZATION

I understand that as a condition of my employment, I will be required to undergo a background investigation and a driver’s license check. I authorize such an investigation to be conducted.

I,  the individual submitting this application,  authorize the Montgomery County Sheriff’s Office to release information regarding any traffic or criminal conviction that I have on file. This authorization is void if not exercised by the person or organization named on this application within (1) one year from the date signed. I hereby agree to indemnify Jefferson Township Board of Trustees and the Montgomery County Sheriff and his representatives for any liability arising out of the improper use of the information provided.

I, the individual submitting this application, certify that the information applied for will be used for the purpose for which it is requested and agree that this information will immediately be destroyed after use or if retained, not released outside my agency.

I, the individual submitting this application, understand, I will be required to pay for their background check and 9-panel drug screen. Applicants will be reimbursed for the cost of their background check and 9-panel drug screen after 90 days of service.

By submitting this application, I agree to the terms listed above.
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First Name *
Last Name *
Email *
Street Address *
City, State, Zip code *
Phone number (included Area Code) *
Social Security Number *
Position Applying For: *
Required
Do you have reliable transportation? *
Date of Birth *
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Have you worked for Jefferson Township in the past? *
Are you a citizen of the United States? *
Please select all positions you will accept: *
Required
When are able to start? *
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