CFA Application

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Apply to the Carrollton Fire Rescue Citizens Fire Academy

Please correct the field(s) marked in red below:

First Name
 *
Last Name
 *
Street Address
 *
City
 *
State
 *
Zip Code
 *
Date of Birth
 *
Texas Driver's License Number
 *
Phone Number
 *
E-Mail
 *

EMERGENCY CONTACT INFORMATION


1. Emergency Contact Name
 *
Address
 *
Phone Number
 *
Email Address
 *
Relationship to Applicant
Cell Phone


Have you ever tried any narcotic drug without a doctor's prescription?
 *
Have you ever tried any narcotic drug without a doctor's prescription?
Have you ever committed a felony or misdemeanor? (other than a traffic violation)
 *
Have you ever committed a felony or misdemeanor? (other than a traffic violation)
Have you ever been arrested and/or convicted of a felony or misdemeanor? (other than a traffic violation)
 *
Have you ever been arrested and/or convicted of a felony or misdemeanor? (other than a traffic violation)
If you answered yes to any of the above questions please explain.

MEDICAL INFORMATION


Known medical conditions or allergies in the event of an emergency:

Please indicate your T-Shirt size:

Please indicate your T-Shirt size:
Men or Women's Style
Men or Women's Style

Background Check Notice and Agreement

As an applicant for Carrollton Fire Rescue’s Citizen Fire Academy, I understand that for security reasons a thorough background check will be conducted. This will include, but not limited to, a detailed Criminal History, NCIC/TCIC and driving record checks.

 

I also understand that all of the information gathered by Carrollton Fire Rescue is confidential and will only be released as required by law. 

 

 

By submitting this form you accept the conditions of the agreement

I accept the conditions of this agreement. 
Signature (Type Name Here)
Date
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