APPLICANT'S EMPLOYER

APPLICANT'S EDUCATION

APPLICANT'S HISTORY

LIST 3-CHARACTER REFERENCES WE MAY CONTACT

ESSAY QUESTIONS

Copies of the following documents MUST be submitted with this application

AUTHORIZATION TO RELEASE INFORMATION

As an applicant for a volunteer membership position with the Elbert Fire Protection District, I am required to furnish information concerning my character, work habits, moral, physical, educational and mental qualifications, including any and all criminal history. In this regard, I authorize Elbert Fire Protection District to make any and all appropriate inquiries, verifications and investigation of all statements contained in this application as may be necessary regarding the pre-mentioned qualifications. Moreover, I authorize those people or organizations selected by Elbert Fire Protection District to release any and all information of a confidential or privileged nature. I hereby release you, and your organization, and all concerned from any liability or damage which may result from furnishing the information requested in connection therewith.

I understand that omission, falsification, or misleading information in this application or other documents submitted in support of this application may result in rejection of this application, removal from an eligibility list, or release of duties as a volunteer member from Elbert Fire Protection District whenever it is discovered. I certify that the information I have provided is true and complete to the best of my knowledge.

AUTHORIZATION TO ACQUIRE BACKGROUND CHECK

I, hereby give permission to Elbert Fire Protection District to acquire a background check.