Resident Firefighter Program Application

Personal Information

Beginning with your present or most recent employer, list your work record for the past 10 years. In evaluating your qualifications, preference will be given to experience during that period. However, if you feel that your work experience beyond 10 years is important, please include it. Also include any periods of self-employment, military service, and any job-related volunteer experience. If more than one position has been held with the same employer, list each one separately. If additional space is necessary, please attach a separate sheet. Complete all sections completely and accurately to the best of your ability.

Employer 1
Employer 2
Employer 3
Employer 4
Professional References
Reference 1
Reference 2
Reference 3
Other Information
After reviewing the job announcement, is there any reason that would prevent you from performing the essential functions of the job for which you are applying with or without reasonable accommodation?
Note: In accordance with the Immigration Reform and Control Act of 1986, employment by Douglas County Fire District No. 2 is contingent upon presentation of acceptable documents verifying identity and authorization for employment in the United States. If offered employment, you are required by federal law to truthfully complete an I-9 form and provide acceptable documents as listed on the form to establish your authorization to work for Douglas County Fire District No. 2. Will you be able to do so prior to the commencement of employment?
Within the past 10 years, have you been convicted of or plead guilty to any crime which might have some bearing on your qualifications and fitness to accept duties and responsibilities of the position for which you are applying?

Note: Although Douglas County Fire District No. 2 may investigate criminal convictions that relate to fitness to perform the job for which you are applying, such convictions may not necessarily bar you from consideration for employment.


Please read carefully before signing.

I certify that all statements made in this application are true, complete, and correct to the best of my knowledge, and that any misrepresentation or omission shall be considered sufficient cause for employment disqualification or discharge.  

I authorize Douglas County Fire District No. 2 to investigate all statements in this application and to secure any necessary information from all my employers, references, and academic institutions.  I hereby release all of those employers, references, academic institutions, and Douglas County Fire District No. 2 from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with Douglas County Fire District No. 2.

In the event of my employment with Douglas County Fire District No. 2, I will comply with all rules, regulations, and policies set forth in Douglas County Fire District No. 2’s policy manual or the communications distributed by Douglas County Fire District No. 2.

I understand that in order for Douglas County Fire District No. 2 employees to respond in the event of any emergency, telephone numbers and addresses of employees are made available within the organization.

I hereby acknowledge that I have read and understand the preceding statements.


Douglas County Fire District No. 2 is an Equal Opportunity Employer and does not unlawfully discriminate on the basis of race, sex, age, color, religion, national origin, marital status, disability status, or any other basis prohibited by federal, state, or local law. In compliance with the Americans with Disabilities Act, disability will be considered only in the context of an applicant’s ability to perform the essential functions of the job and to determine reasonable accommodation.