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#1905-FFF48K-001
Supplemental Questionnaire

Last Name
First Name

 

Supplemental Questionnaire


INSTRUCTIONS: Completion of this supplemental questionnaire is REQUIRED. Please read each question carefully and provide clear and complete responses that accurately portray your education and relevant work experience. Your qualifications for employment will be evaluated based upon the information you provide in your responses below and then verified by our staff who will review your entire application for completeness and determine qualification status.

The employers and dates of employment that you list on this supplemental questionnaire MUST match the employers and dates of employment provided in the work experience section of your employment application. Failure to provide matching employer, and dates of employment may result in your application being "not qualified" for this recruitment.

IMPORTANT NOTE: "See Resume" is not an acceptable response to any of the open-ended questions on this questionnaire and will result in your application being "not qualified" for this recruitment.



 

Do you possess a High School Diploma or GED certificate?

Yes No
 

Do you possess a valid Fire Fighter's Certification of Compliance issued by the State of Florida?

Please upload a copy of your certification before submitting your application.

Yes No
 

In the box below, list your Fire Fighter's Certification of Compliance issued by the State of Florida Certification #

 

Do you possess a valid State of Florida Emergency Medical Technician (EMT) or Paramedic (EMT-P) Certification?

Please upload a copy of your certification before submitting your application.

Yes No
 

In the box below, list your State of Florida Emergency Medical Technician (EMT) or Paramedic (EMT-P) Certification #

 

The Candidate Physical Abilities Test (CPAT) and the National Testing Network (NTN) Fire Team tests are required to submit an application for this position and must be active through your first day of employment.

It is your resonsibility to obtain and maintain a valid CPAT and NTN Fire Team test. Do you understand that you must possess a valid CPAT and NTN Fire Team test to be considered for this position with Hillsborough County Fire Rescue?

Yes No
 

Additional Requirements of this position that must be met are as follows:  

  • No felony convictions
  • No convictions of a misdemeanor relating to the certification or to perjury or false statements
  • No convictions of a DUI in the past 3 years
  • No convictions of a crime punishable by imprisonment of 1 year or more under the law of the United States or of any state thereof or under the law of any other country
  • Applicant has not obtained 7 or more points on driving record within the past 3 years
  • Prior military personnel must not have a dishonorable discharge from a branch of the United States Armed Forces, The United States Coast Guard, National Guard or Reserve Forces.

  • All Candidates must be tobacco or tobacco products free for at least one (1) year preceding their application for employment as a Firefighter / Fire Medic, in accordance with Section 633.34(6), Florida Statutes. 

Note: “Convicted” means a finding of guilt or the acceptance of a plea of guilty or nolo contendere, in any federal or state court or a court in any other country, without regard to whether a judgment of conviction has been entered by the court having jurisdiction of the case. 

Do you meet all of these requirements?

Yes No
 

As a condition of employment you must obtain a State of Florida Paramedic Certification within 3 years of your hire date.

Do you agree to obtain a State of Florida Paramedic Certification within 3 years of your hire date?

Yes No
 

Uploading a copy of all requested Certifications is a requirement to be considered for this position. Do you understand this requirement? 

Yes No
 

Do you possess a valid Driver's License?

Yes No
 

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By checking the box above, I certify that all of my responses are true and complete, and any misstatement of material facts OR failure to completely answer questions or provide my employer with a copy of any licenses, certifications, or other documents listed on the job announcement will subject me to disqualification from the application process and/or dismissal from employment.

I also authorize investigation of all statements contained in my application, to include a formal background check that may require education and employment verification; criminal history; and motor vehicle driving report as may be necessary in arriving at an employment decision. Further, I acknowledge understanding that an offer of employment will be subject to successfully passing a drug screen and physical.

I also understand that once I submit my application for this recruitment, I cannot edit it later.