City of Massillon FIRE Employment ApplicationFull Name*Full name is requiredEmail*Home PhoneMobile PhoneAddress*City*State* ALAKARAZCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYPostal CodeMinimum QualificationsDo you hold a Valid Drivers License?* Yes NoHave you ever been convicted of a felony?* Yes NoIf YES, please explain in detail.Are you at least eighteen (18) years of age but not yet forty (40) years of age?* Yes NoDo you hold a High School Diploma or GED?* Yes NoAre You Legally Eligible to Work in the U.S.? * Yes NoDo you possess a Firefighter II Certificate by the Ohio Department of Public Safety?* Yes NoDo you possess a Paramedic Certificate by the Ohio Department of Public Safety?* Yes NoDo you possess a Certification of Completed Firefighter Physical Assessment test by an accredited institution in Ohio within the last 6 months?* Yes NoBONUS Qualifications and InstructionsThe City of Massillon offers bonus opportunities, on passing scores of 70% or higher to be added to your written examination. A highest amount to be earned is a total of 20%. Accepted items are below. You will be contacted by Civil Service upon completion of the application with instructions on submitting Bonus documentation. Please check off any bonus qualifications that you have: 15-20% Military 10% Associates Degree in like field 15% Bachelors Degree in like fieldDisclaimerI hereby certify that the answers and statements made on this application are true and correct. I am aware that a representative from the City of Massillon may conduct an investigation of my background to assist in determining my suitability for this employment. I further understand that any applicant who intentionally makes a false statement or who practices fraud in filling out this application will be refused employment. If already appointed, subsequent evidence of misrepresentation will be considered cause for termination of employment. I hereby authorize all my previous employers and references to furnish any information concerning my personal character, health, reputation, habits and work records. I hereby release all such persons and the City of Massillon from liability or damages incurred as a result of furnishing or obtaining this information. Signature*DateIf you are human, leave this field blank.