MCAFA - Marine City Area Fire Authority

Online Application Form

Equal access to programs, services and employment opportunities is available to all persons without regard to race, religion, color, sex (including pregnancy), age, national origin, disability, marital status, height, weight, genetic information, or any other protected status under applicable federal, state, or local law.

Complete the following application form and click the Submit button at the bottom when finished.

Last name (required)

First name (required)

Middle name (required)

Street address (required)

City (required)

State (required)

Zipcode (required)

Telephone number (required)

Telephone type (home, cellular, etc.) (required)

Email address (required)

Position applied for (required)

Date of application (mm/dd/yyyy) (required)

Referral source (Walk-in, Job Posting, MCAFA website, etc.) (required)

Best time to contact (ex. 6-10pm, 10am-2pm, anytime, etc.) (required)

Have you submitted an application here before?
YesNo

If Yes, give date(s) and position(s):

Have you ever been employed with MCAFA?
YesNo

If Yes, give date(s):

Are you lawfully authorized to work in the United States?
YesNo

Are you able to perform the "essential functions" of the job for which you are applying?
YesNo

Have you ever pleaded "guilty" or "no contest" to or ever been convicted of a crime?
YesNo

If Yes, give details:

EMPLOYMENT HISTORY - Starting with your most recent employer, provide the following information for your last two jobs

Most recent employer

Employer

Street address

City

State

Zipcode

Telephone number

Immediate Supervisor and Title

Reason for leaving

May we contact for reference?
YesNoLater

If Yes, what is their email address?

Dates employed (month/year to month/year):

Starting compensation

Hourly or Salary?
HourlySalary

Compensation (ex. $15 per hour, $500 per week, $2500 per month, etc.)

Commissions/Bonus/Other Compensation (enter $ amount)

Final compensation

Hourly or Salary?
HourlySalary

Compensation (ex. $15 per hour, $500 per week, $2500 per month, etc.)

Commissions/Bonus/Other Compensation (enter $ amount)

Summarize the type of work performed and job duties:

What did you like most about your position?

What were the things you liked least about your position?

Previous employer

Employer

Street address

City

State

Zipcode

Telephone number

Immediate Supervisor and Title

Reason for leaving

May we contact for reference?
YesNoLater

If Yes, what is their email address?

Dates employed (month/year to month/year):

Starting compensation

Hourly or Salary?
HourlySalary

Compensation (ex. $15 per hour, $500 per week, $2500 per month, etc.)

Commissions/Bonus/Other Compensation (enter $ amount)

Final compensation

Hourly or Salary?
HourlySalary

Compensation (ex. $15 per hour, $500 per week, $2500 per month, etc.)

Commissions/Bonus/Other Compensation (enter $ amount)

Summarize the type of work performed and job duties:

What did you like most about your position?

What were the things you liked least about your position?

If not addressed, have you ever been fired or asked to resign from a job?
YesNo

If Yes, please explain:

Summarize any special training, skills, languages, licenses and/or certificates that may assist in performing the position which you are applying for:

Education Background - Starting with your most recent school attended, provide the following information:
Most Recent School
School Name

School City

School State

Number of years completed

Type of degree completed
DiplomaGEDDegreeCertificationOther
If Degree, Certification, or Other, please provide the name/detail:

GPA Class Rank

What was your Major/Minor?

Previous School (if applicable)
School Name

School City

School State

Number of years completed

Type of degree completed
DiplomaGEDDegreeCertificationOther
If Degree, Certification, or Other, please provide the name/detail:

GPA Class Rank

What was your Major/Minor?

2nd Previous School (if applicable)
School Name

School City

School State

Number of years completed

Type of degree completed
DiplomaGEDDegreeCertificationOther
If Degree, Certification, or Other, please provide the name/detail:

GPA Class Rank

What was your Major/Minor?

PERSONAL REFERENCES - List the names and telephone numbers of three personal references who are NOT related to you and are NOT previous supervisors
1st Reference
Name

Title

Relationship to You

Telephone

Email

Number of years you've known them

2nd Reference
Name

Title

Relationship to You

Telephone

Email

Number of years you've known them

3rd Reference
Name

Title

Relationship to You

Telephone

Email

Number of years you've known them

Any other job-related information you want us to know?

APPLICANT STATEMENT
I certify that all information I have provided in order to apply for and secure work with this employer is true, complete, and correct.
I expressly authorize, without reservation, the employer, its representatives,
employees or agents to contact and obtain information from all references (personal and professional), employers,
public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all
information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims
I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such
information in the employment process and all other persons, corporations or organizations for furnishing such
information about me.
I understand that the employer does not unlawfully discriminate in employment and no
question on this application is used for the purpose of limiting or excusing any applicant from consideration for
employment on a basis prohibited by applicable local, state or federal law.
I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be
considered for employment, it will be necessary to reapply and fill out a new application.
If I am hired, I understand that I am an “at will” employee whereas I am free to resign at any time, with or without cause and without prior notice and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, unless otherwise required by law. This
application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or
representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing
express language are valid unless they are in writing and signed by the employer’s president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
I understand that reasonable safeguards will be taken to protect all personal information provided or obtained in conjunction with this application for employment. My personal information may be shared with the employer's affiliate(s) and third parties engaged by the employer to perform services for the employer. Any personal information shared with an affiliate or third party is to be used solely to perform services requested by the employer.
This company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her race, religion, color, sex (including pregnancy), age, national origin, disability, marital status, height, weight, genetic information, or any other protected status under applicable federal, state or local law.
I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered.
DO NOT CHECK THE BOX BELOW UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
YesNo - I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement. (required)
Electronic Application Submission:
YesNo - I agree to use an electronic or typed signature and that any physical or electronic copy of this form can be used as if it were a physically-signed original and therefore considered legally binding. (required)
Signature (required):
- Type your name in the space below

Date (mm/dd/yyyy)(required):