Carrollton Fire Department Firefighter Pre-Application

CARROLLTON FIRE DEPARTMENT PRE-APPLICATION
Candidate’s First Name*
Candidate’s Last Name*
Suffix such as Jr., Sr., II, III, etc
Which position are you applying for?*
Race
Sex/Gender
Present Mailing Address
Physical Home Address
Present Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Physical Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Cell Phone
Work Phone
Other Phone
Email*
example@example.com
Are you related by blood or marriage to any person(s) now employed by the City of Carrollton?*

YesNo
If yes, give name(s) and relationship
Are you applying as a Certified Firefighter or Non-Certified?*

Currently CertifiedPreviously Certified (Last year certified)Non-Certified
Last year certified
Qualifications to Compete for Employment
Minimum Requirements Checklist

United States CitizenMinimum age of 18Valid U.S. Driver's LicenseVeterans Must have an Honorable DischargeHigh School Diploma or GED CertificateMust Pass Physical Agility TestHave Good Moral CharacterNo Felony Convictions in Previous 10 Years
Applicants must also meet the requirements as set forth in Georgia Code 25-4-8 of the Georgia Firefighter Standards and Training Council. Requirements for appointmentor certification of persons as Firefighters, must be met before the effective date of hiring. Additional requirements may be mandated at the discretion of the City of Carrollton and the Fire Chief such as: present Firefighter Certification, prior completion of an academy training program, or pertinent levels of education, and/or levels of experience or combination of the experience and education.
Drivers License Front

Cancelof
Drivers License Back

Cancelof
Signature*

Clear
Date*

MonthDayYear
Date
APPLICANT CHECKLIST
Contact Deputy Chief Lambert by email for an appointment

blambert@carrollton-ga.gov
Please check each box indicating you have the documentation below.*

1. Current Driver’s License.2. Copy of your DD-214, if served in the military.3. Proof of Educational Status, High School Diploma or GED Certificate in addition to Official/Certified copies of all transcripts High School, College, Technical School, etc.4. Fire Academy Certificates, if applicable.5. Birth Certificate (original NOT a copy)
You must also be prepared to provide the following information:
- References: Six (6) Name, address, home, and work telephone numbers (these must be three (3) personal and three (3) work references.)
- Complete work history: Employer names, addresses, dates of employment, and reason for leaving. Explain any breaks in employment.
- List of current and previous addresses.
- Also, be prepared to list any traffic citations, (offense and disposition) you have received.
- Be prepared to list any traffic accidents in which you have been involved.
- Be prepared to complete a physical agility test.
- Be prepared to complete a thorough background check.
- Be prepared to complete a drug screen.
- Be prepared to write a full 8.5” x 11” page about yourself.
Applicants must answer truthful and fully all questions asked of them. Any misrepresentation or omission of any material fact on the application, during the application, background investigation, or in any phase of the selection process shall disqualify the applicant. If an investigation discloses a willful misrepresentation, omission, or falsification, the application will be rejected, and the applicant may be permanently disqualified from applying in the future for any position in the Carrollton Fire Department.

The City of Carrollton does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services. All individuals considered for employment are evaluated without regard to race, color, religion, gender, national origin, age, marital, or veteran status, the presence of a non-job-related disability or any other legally protected status.
Should be Empty:

CARROLLTON FIRE DEPARTMENT PRE-APPLICATION

Qualifications to Compete for Employment

APPLICANT CHECKLIST