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Thank you for your interest in becoming a City of Carbondale Firefighter! The purpose of this application is to assist the City of Carbondale in selecting the best qualified persons available to serve the community as Firefighters in the Fire Department. It also serves as an aid to the Fire Chief to avoid employing anyone who does not have the specific qualities that are a necessity in fulfilling the rigorous responsibility of the public safety profession in the Fire Department.
If you are divorced, you do not need to submit your marriage license.
(A copy of a driver's license or an ID card IS NOT ACCEPTABLE.)
Please provide a valid email address. Most correspondence will be sent by email. Notify the City Clerk's office if any of your contact information changes.
(There are some limitations on the employment of relatives. Each case is considered separately for potential conflict of interest.)
(Give Maiden/Married Name, if applicable)
(Maiden Name if Wife)
List your addresses starting with present address:
Choose the highest grade completed.
Fill in below the name of three adults not related to you and not former employers, who have known you for a period, preferably more than five years. All people to whom you refer will be asked to evaluate your character, ability, experience, personality, and other qualities.
List name(s) of person(s) to be notified in case of emergency.
List in proper time sequence all full-time, temporary, and part-time jobs you have held in the past 10 years. Put your present or most recent job first.
Section 1-4-16 of the City Code requires that all new City employees in Pay Grades 1-7 must establish residency within the City Residency Boundary within a six (6) month period following the date of hire and remain residents within the Residency Boundary as a condition of continued employment.
The Residency Boundary includes all of Carbondale, Murphysboro, DeSoto and Makanda Townships and portions of Somerset and Pomona Townships in Jackson County, and portions of Grassy, Carterville and Blairsville Townships in Williamson County.
Section 1-4-16 of the City Code requires that all new City employees in Pay Grades 8 and 9 must establish residency within Carbondale's corporate limits within a six (6) month period following the date of their hire and remain residents within Carbondale's corporate limits as a condition of continued employment.
For further information, contact the Human Resource's Office.
I certify that all statements made in this application are true, complete and correct to the best of my knowledge, and that any false statement shall be considered sufficient cause for employment disqualification or discharge.
I authorize my current or former employer(s) to provide to the City of Carbondale representatives any information regarding my current or former employment. I understand that such information may or may not help my application for employment with the City of Carbondale. I hereby release any current or former employer, its agents or employees, from any and all liability resulting from the release of such information. My authorization to current or former employers to release information and my waiver of liability, which are written above, are knowing, intelligent and voluntary acts.
I authorize schools and other educational and technical institutions which I have attended to release my scholastic ratings or records to the City of Carbondale.
I hereby authorize the Carbondale Police Department, the Illinois State Police and/or any other law enforcement agency to release any and all information relating to my criminal record to the Human Resources Division of the City of Carbondale. I agree to release all parties from liability for any damages that may result from furnishing the same to the Human Resources Division of the City of Carbondale. I further agree to hold harmlessly any law enforcement agency which provides criminal history information about me to the Human Resources Division of the City of Carbondale.
I am willing and understand employment with the City of Carbondale is subject to passing a pre-employment physical examination, which may include drug and alcohol screening that are made by a Physician designated by the City of Carbondale.
I understand that as a condition of employment and within 3 days of being employed, I must provide documentation to prove employment eligibility and personal identification as required by the Immigration Reform and Control Act of 1986.
Please note: No applicant is obligated to disclose any expunged records, adjudication or arrest while they were a juvenile pursuant to Illinois Public Act 100-0285, including any ordinance violations. Furthermore, any information obtained through this application process regarding any expunged juvenile record is confidential and WILL NOT be disclosed in any manner by the City of Carbondale.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
If there is insufficient space in the application to provide an answer or explanation, use this section or upload additional sheets. Indicate in the left hand column the number of the question you are answering then complete your answer in the space provided.
The City of Carbondale prohibits discrimination in employment in regard to race, color, religion, sex, age, national origin, marital status, sexual orientation, ancestry, physical or mental handicap unrelated to ability, or unfavorable discharge from military service.
As an employer with an Affirmative Action Program, we comply with government regulations, including Affirmative Action responsibilities where they apply.
The purpose for this information is to comply with government record keeping, reporting and other legal requirements. Periodic reports are made to the government on the following information. The completing of this information is optional. If you choose to volunteer the requested information, please note that all information is kept in an Affirmative Action file and is not a part of your Application for employment or personal file.
Your cooperation is voluntary. Inclusion or exclusion of any date will not affect any employment decision.
Government agencies at times require periodic reports on the sex, ethnicity, handicap, veteran and other protected status of employees. The data is for statistical analysis with respect to the success of the Affirmative Action Program. Submission of this information is VOLUNTARY.
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