www.houstontx.gov > Houston Fire Department > Applicant Interest Form

APPLICANT INTEREST FORM

By submitting this Interest Form your name will be added to our Contact List. Those on the list will be contacted when the next Civil Service Exam is available. This is NOT a job application. Once we have a test posted you will have to sign up for the Civil Service Exam using NeoGov.

All fields are required to be completed, except those noted with a *

APPLICANT INTEREST FORM
 
CONTACT INFORMATON
Full Name:
*
Last First M.I.
 
Address:
*
Street Address
Apartment / Unit #
City
State
Zip Code
 
Main Phone:
Alternate Phone:
 
Social Security #
Driver License # (include State issued)
 
Date of Birth
Sex:
Male
Female
 
Race/Ethnicity:
White
  
Black
  
Hispanic
  
Other
*
Nat'l Origin:
 
Email Address:
 
EDUCATION
 
HS Diploma: yes no GED: yes no
 
College Hours Earned: *
 
Associate *
 
Bachelors *
 
Masters *
 
Certifications:*
Fire
EMT
Paramedic
 
Military: yes no honorable
(check if yes) 		ETS (date)
*
 
RERERRAL SOURCE
Referral Source (choose as many as apply):
Fire/EMT School Internet HFD Employee
Job/Career Fair Newspaper/Media Self Referred
Military Family/Friend Other
     
Which Other?
*
 
COMMENTS & QUESTIONS
*
 
JOB SPECIFIC SUPPLEMENTAL QUESTIONS
1A. Do you have: at least sixty (60) transferable semester college hours with a Grade of “C” or higher from an accredited college or university?
YES
.
NO
or ...
1B. Do you have: (2) years of full time (active duty) military service with an “honorable discharge?”
YES
.
NO
 
2. Have you used any illegal street drugs within the last year?
YES
.
NO
 
3. Do you have more than 2 moving violations (traffic) convictions within the last three (3) years? (This does not include DWI's and/or DUI's)
YES
.
NO
4. Do you have any criminal charges currently pending?
YES
.
NO
5. Are you on parole or probation, deferred adjudication or under a pre-trail diversion agreement for a Misdemeanor A or Felony?
YES
.
NO
6. In the last 10 years, were you ever convicted of a violation of any criminal laws whether Misdemeanor A or Felony, but not including parking, speeding, or other moving violations?
YES
.
NO
7. Do you have a valid driver's license?
YES
.
NO
.
I certify that all the information provided by me in connection with my application is true and correct to the best of my knowledge and I understand that any misstatement, falsification, or omission of information shall be grounds for refusal to hire, or, if hired, termination. (Check if yes)