Apply online or in personCarthageFD11@gmail.com(315) 493-2346685 S. James StreetCarthage, NY 13619 Qualified applicants are considered without regard to race, color, creed, sex, national origin, age, marital or veteran status. Name * First Name Last Name Address * How long have you resided at this address? * Phone # * (###) ### #### Email Date of Birth * MM DD YYYY Please describe any previous firefighting experience Have you even been convicted of a misdemeanor or felony? * No Yes If yes, please explain Have you ever been convicted of an arson related crime? * No Yes Do you have a valid NYS Drivers license? * Yes No Do you have any physical, mental or medical impairment or disability that would limit your ability to be a volunteer firefighter? * No Yes If yes, please explain Are you currently employed? * Yes No May we contact your employer as a reference? Yes No Employer Employer Phone Number (###) ### #### Please give name and telephone number for three (3) references that are not your immediate relatives: Reference 1 * First Name Last Name Reference 1 phone # * (###) ### #### Reference 2 * First Name Last Name Reference 2 phone # * (###) ### #### Reference 3 * First Name Last Name Reference 3 phone # * (###) ### #### Submitting this application gives consent for inquiries and investigation of applicant to help determine if eligible to become a firefighter of the Carthage Fire Department. Thank you! Your application will be reviewed and you will be contacted soon.