Clarinda Fire & Rescue

Please use this online form to make your application, or you can download our pdf version and bring it into the station.
To download the pdf CLICK HERE.

DATE
NAME	EMAIL
D.O.B	HOME PHONE #
HOME ADDRESS
DO YOU OWN A CAR OR PICKUP? Yes No
OCCUPATION
EMPLOYER	WILL EMPLOYER RELEASE YOU TO RESPOND TO INCIDENTS DURING WORK? Yes No
IF ABOVE IS ANSWERED NO WILL YOU BE RELEASED ON SECOND ALARMS?Yes No
WHAT EXPERIENCE WILL YOU BRING OUR DEPARTMENT
I ALSO GIVE THE FOLLOWING REFERENCES:
EMPLOYER	PHONE#
PERSONAL	PHONE#
PERSONAL	PHONE#
BY THIS APPLICATION I AGREE TO ABIDE BY ALL RULES AND REGULATIONS OF CLARINDA FIRE & RESCUE INCLUDING RESPONSE TO INCEDENTS AND ATTENDANCE AT TRAINING SESSIONS. I ALSO AGREE TO SUBMIT TO A PHYSICAL EXAMINATION AS REQUIRED BY THE DEPARTMENT. IN REGARD TO MY POSSIBLE APPOINTMENT TO CLARINDA FIRE & RESCUE, I AUTHORIZE THE CITY MANAGER OF THE CITY OF CLARINDA TO INVESTIGATE MY PAST DRIVING RECORDS THROUGH THE APPROPRIATE LAW ENFORCEMENT AGENCIES.