Apply Now

If you have any questions concerning this application, please call the Fire Department at (816) 628-4122, Monday through Thursday between the hours of 8:00 AM and 5:00 PM or email Rhonda Fort at Rfort@kearneyfire.org

Attached is my application for employment with the Kearney Fire & Rescue Protection District. I have given my full name, address, and other pertinent information as requested. I understand that this application must be completed in its entirety in order to receive consideration.

I certify that I have carefully completed this application, and that I have given all information herein without omission or falsification. I further attest that no information has been withheld about me or my background which may cause concern to you in any way, should you give me employment with the Kearney Fire & Rescue Protection District.

I also certify that I am at least eighteen (18) years of age (14 years of age for Jr. Firefighter); a citizen or legal resident of the United States; hold a current Missouri driver’s license; have a social security number; and have a high school diploma or GED equivalent.

By signing my name to this letter, I consent to the investigation of all facts and circumstances given in the attached application for membership to the Kearney Fire & Rescue Protection District. I also consent to the interview of any references provided herein, and to any background investigation needed by any law enforcement organization. I understand that I am subject to an agility test, a physical examination, and a drug screen.

I fully understand that should any information provided herein be investigated and found to be false, that I will be subject to immediate dismissal from the Kearney Fire & Rescue Protection District without recourse.

"*" indicates required fields

Employment Type

Position Requested
Employment Type

Personal Information

Applicant Name
Address
Gender*

Military Service

Have you served in the Armed Services?

Employment History

Work Address

If less than five (5) years with present employer, list previous employer(s)

Work History
Employer
Phone
Reason for Leaving
Employment Dates
 

Fire Department Experience

List
Fire Department
Address
Dates
 

Background Information

Do you have charges pending or have you admitted guilt or been found guilty of committing any felony or misdemeanor? (Include offenses for which probation was granted, excluding minor traffic violations but including DWI.)

Education History

Education (High School & College)
Institution Name
Address
Date of Attendance
Diploma/Degree
 

Fire & EMS Certifications

Firefighter
Level: I or II?
Original Date
Current Date (if applicable)
Expiration Date (if applicable)
 
Haz-Mat
Level: Ops or Technician?
Original Date
Current Date (if applicable)
Expiration Date (if applicable)
 
State of Missouri EMT License
Original Date
Current Date (if applicable)
Expiration Date (if applicable)
 
Current AHA BLS/ACLS Provider
Original Date
Current Date (if applicable)
Expiration Date (if applicable)
 
State of Missouri Paramedic License
Original Date
Current Date (if applicable)
Expiration Date (if applicable)
 
Drop files here or
Max. file size: 50 MB.

    Other Skills, Training, Interests

    References

    List three (3) references, other than relatives.
    Reference List
    Name
    Address
    Phone
     

    Emergency Contact Information

    List
    Name
    Relation
    Phone
     

    Applicant's Statement

    Clear Signature
    MM slash DD slash YYYY
    This field is for validation purposes and should be left unchanged.