Firefighter Application

About You

Full Name (including middle initial)

Birth Date

Age

Address

Length of Residency at Current Address

Cell Phone

Home Phone

Military Service & Branch

Military Service: If Other, Please Describe

Employment

Current Employer

Current Employer Address & Phone

Job Title & Supervisor

Previous Employer

Previous Employer Address & Phone

Job Title & Supervisor

Physical

Height & Weight

Do you wear glasses / contacts?

References

Name #1 & Address

Phone & Years Known

Name #2 & Address

Phone & Years Known

Education & Training

High School (include City, State)

Year of Graduation or GED

College (include City, State)

Year of Graduation

If you currently or have had previous Fire/Rescue Department Affiliation, which Department and membership dates?

If applicable, List ranks as well as relevant training and certification information

Please upload all relevant certifications

Unlimited number of files can be uploaded to this field.
256 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

If you are current EMT Certified, which level and State Number?

If you are CPR certified, what is expiration date?

Miscellaneous

Have you ever been convicted of a felony?

If yes, what year?

Have you ever applied to the Granger Fire Department before?

if yes what year?

Contact Us

Granger City Hall 1906 Main Street Granger IA 50109 515-999-2210 City Directory

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