Seasonal Fire Application



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SEASONAL WILDLAND FIRE APPLICATION

|POSITION APPLYING FOR: |ARE YOU CURRENTLY RED CARDED? |SOCIAL SECURITY NUMBER |

|FOREST FIRE FIGHTER |YES NO |      |

|ENGINE LEADER / SQUAD BOSS | | |

|HELITACK Fire fighter | | |

|HeliTACK SQUAD BOSS | | |

|HELICOPTER MANAGER | | |

|Helitack FUEL SUPPORT TRUCK DRIVER (Note: Special CDL | | |

|requirements apply) | | |

| |Have you previously worked for dnr? |HOME PHONE |

| |YES NO |      |

| | | |

| |What position did you have last? | |

| |      | |

| | |MESSAGE/CELL PHONE |

| | |      |

|ARE YOU WILLING TO TRAVEL? |AVAILABLE EMPLOYMENT DATES |DATE OF BIRTH |

|YES NO |FROM:      TO:      |      |

|NAME (LAST, FIRST, MIDDLE INITIAL) |E-MAIL ADDRESS |

|      |      |

|PERMANENT ADDRESS (PHYSICAL) |PERMANENT CITY, STATE, ZIP CODE |

|      |      |

|SUMMER ADDRESS (MAILING, if different) |SUMMER CITY, STATE, ZIP CODE |

|      |      |

|Which address would you like mail sent to: |DO YOU HAVE A VALID DRIVER LICENSE? |

|permanent summer |YES NO IF YES, WHAT STATE?       |

|HOW MANY YEARS OF DRIVING EXPERIENCE DO YOU HAVE? |Commercial Drivers License (CDL) |EXPIRATION |

|Less than 2 2-4 Greater than 4 years | |      |

| |A B C | |

|DRIVER LICENSE NUMBER |EXPIRATION |OTHER |EXPIRATION |

|      |      |      |      |

|MY DRIVING RECORD IS FREE OF THE VIOLATIONS LISTED BELOW: |If NO list the violations: |NOTE: Interview candidates will be |

| | |required to provide the interview |

|YES NO | |panel with: (1) a copy of their |

| | |driver’s license and, (2) an |

|Within the past 3 years any suspension/revocation of license for reckless driving,| |Employment driving record obtained |

|hit and run, leaving an accident scene, failure to appear, DUI, or other vehicle | |for a fee from the state in which you|

|related felony, or for multiple traffic offenses (4 moving violations/infractions | |are currently licensed. In |

|in 12 months/5 moving violations/infractions in 24 months) resulting in a | |Washington that is through the |

|conditional status driving record or subsequent suspension revocation of license, | |Department of Licensing. |

|or 6 or more moving violations within a 12 month period resulting in a license | | |

|suspension. | | |

|Have you been convicted of a misdemeanor or felony within the past ten years? (Answering yes will not automatically DISQUALIFY you from employment.) |

|YES NO IF YES, EXPLAIN:      |

|LANGUAGES SPOKEN FLUENTLY OTHER THAN ENGLISH: |

|List any relevant wildland fire training or |List Red-Card qualifications you currently hold: |

|coursework: | |

|      |Chainsaw Operator CREW BOSS OTHER _________________ |

| |Helicopter Crewmember FELLING BOSS OTHER _________________ |

| |Firefighter 2 ENGINE BOSS |

| |firefighter 1 DOZER BOSS |

| | |

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|EDUCATION |

|HIGH SCHOOL GRADUATE OR |IF NO, CHECK HIGHEST GRADE COMPLETED |

|GENERAL EDUCATION DEVELOPMENT TEST PASSED? |1 2 3 4 5 6 |

|YES NO GRADUATION DATE: ___________ |7 8 9 10 11 12 |

|BELOW, LIST YOUR POST HIGH SCHOOL TRAINING, COLLEGE, MILITARY, ETC |

| |ATTENDED |CREDITS EARNED |GRADUATED YES/NO |DEGREE |MAJOR OR SUBJECT |

|NAME AND LOCATION |MO/YR | | |YEAR |TAKEN |

| | |QUARTER |SEMESTER | | | | |

| | |HOURS |HOURS |OTHER | | | |

|      |

|1. Last or Present EMPLOYER      Telephone No.:      |FROM (Month/Year) |

| |      |

|Your Title:      Employer's Address:      | |

|SPECIFIC DUTIES |TO (Month/Year) |

|      |      |

| | |

| | |

| | |

| |Total Months Employed: |

| |      |

| | |

| |Hours/Wk |Last Salary |

| |      |      |

| | | |

| |Immediate Supervisor: |

| |      |

|Reason for Leaving      No. of Employees Supervised:      | |

| |

|2. previous EMPLOYER      Telephone No.:      |FROM (Month/Year) |

| |      |

|Your Title:      Employer's Address:      | |

|SPECIFIC DUTIES |TO (Month/Year) |

|      |      |

| | |

| | |

| | |

| | |

| |Total Months Employed: |

| |      |

| | |

| |Hours/Wk |Last Salary |

| |      |      |

| | | |

| |Immediate Supervisor: |

| |      |

|Reason for Leaving      No. of Employees Supervised:      | |

| |

|3. previous employer      Telephone No.:      |FROM (Month/Year) |

| |      |

|Your Title:      Employer's Address:      | |

|SPECIFIC DUTIES |TO (Month/Year) |

|      |      |

| | |

| | |

| |Total Months Employed: |

| |      |

| | |

| |Hours/Wk |Last Salary |

| |      |      |

| | | |

| |Immediate Supervisor: |

| |      |

|Reason for Leaving      No. of Employees Supervised:      | |

| |

You may attach a resume if you have additional work experience.

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Please list or describe any additional skills or experience gained through volunteer work, internships etc., which you believe are relevant to the position for which you are applying.

     

Describe, in the space provided below, why you would like to work for the Department of Natural Resources performing wildland fire suppression?

     

I am able to provide my own housing arrangements for the location (s) I am applying for.

(Note: Shared crew housing is provided at: Ahtanum, Forks, Highlands and Pt Angeles)

Yes No

All answers and statements are true and complete to the best of my knowledge. I understand that untruthful or misleading answers are cause for rejection of my application, removal of my name from the register, or dismissal, if employed.

| | |

|      |      |

SIGNATURE DATE

The Department of Natural Resources is a harassment and drug free workplace.

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Authorization to Release Information

I __________________________________________ (print name) authorize the Washington State Department of Natural Resources to contact all of my former or present employers and other personal references for the purposes of verification and reference. This may include information of a confidential or privileged nature, including but not limited to reviewing my personnel file, contacting any references, and/or contacting anyone else who might be familiar with my past job performance.

I knowingly and voluntarily release the state of Washington, the Department of Natural Resources, its individual employees, and all my former or present employers, and their individual employees, from any and all known and unknown claims for damages or other relief arising out of the Department’s request for and receipt of employment information, unless my current or former employer is prohibited by state or federal law from disclosing the information that the department requests.

A printed copy of this Authorization is as valid as the original and shall be provided to anyone from whom information is requested in determining my job qualifications.

This release will expire at the end of the recruitment period.

| | |

|      |      |

ELECTRONIC SIGNATURE (Type your full name to indicate agreement) DATE

OR,

| | |

|      |      |

HANDWRITTEN SIGNATURE DATE

Geographic Availability sheet PAGE 5 of 5

[pic]

|CHOOSE ONE REGION where you will be available to *reside and work. |

|*Employees must reside within a short commute of their crew assembly point which is typically considered to be within 35 miles or equivalent commute time. |

|If you are applying for more than one Region, you must submit a separate application and geographical availability sheet to that Region. |

|AFTER YOU HAVE SELECTED A REGION, indicate the location or geographic area(s) of preference. The geographic areas of availability are listed under each Region.|

|Indicate your preference(s) by placing a 1 for first choice, 2 for second choice, 3 for your third choice in front of the geographic area(s) where you would be|

|available to work. (You may choose up to three geographic areas within a Region per application.) |

|SUBMIT APPLICATION PACKET, including the Geographic Availability Sheet, to the APPROPRIATE REGION. |

|(Packets missing the Geographic Availability page cannot be processed.) |

|Northwest Region |

| |Island County | |Snohomish County | |

|Pacific Cascade Region |

| |

| |Aberdeen | |Port Angeles | |

| | | |Shared crew housing on-site | |

| |Forks | |Port Townsend | |

| |Shared crew housing on-site | | | |

|South Puget Sound Region |

| |Belfair | |Enumclaw | |

| |Eatonville | |Shelton | |

|Southeast Region |

| |

| |Curlew/Republic/Tonasket | |Deer Park/Newport/Spokane |

|Northeast | | | |

|Region |Ferry |Heidi Seitters |Department of Natural Resources |

| |Lincoln | |Northeast Region |

| |Okanogan |heidi.seitters@dnr. |225 S Silke Road |

| |Pend Oreille |Phone: (509) 684-7474 |Colville WA 99114-0190 |

| |Spokane |Fax: (509) 684-7484 | |

| |Stevens | | |

|Northwest Region |Island | | |

| |San Juan |Shesha Zavala |Department of Natural Resources |

| |Skagit | |Northwest Region |

| |Snohomish |shesha.zavala@dnr. |919 N Township Street |

| |Whatcom |Phone: (360) 856-3500 |Sedro Woolley WA 98284-9395 |

| | |FAX (360) 856-2150 | |

|Olympic Region | | | |

| |Clallam |Cindy Sanders |Department of Natural Resources |

| |Jefferson | |Olympic Region |

| |N Grays Harbor |olympicregionjobs@dnr. |411 Tillicum Lane |

| | |Phone: (360) 374-2800 |Forks WA 98331-9797 |

| | |FAX: (360) 374-5446 | |

|Pacific Cascade |Clark | | |

|Region |Cowlitz |Judy Hainline |Department of Natural Resources |

| |Lewis | |Pacific Cascade Region |

| |Pacific |judy.hainline@dnr. |PO Box 280 |

| |S Grays Harbor |Phone: (360) 577-2025 |Castle Rock WA 98611-0280 |

| |Skamania |FAX: (360) 274-4196 | |

| |Thurston | | |

| |Wahkiakum | | |

|Southeast | |Sally Bollinger | |

|Region |Asotin |sally.bollinger@dnr. |Department of Natural Resources |

| |Chelan |Phone: (509) 925-0918 |Southeast Region |

| |Garfield |FAX: (509) 925-8522 |713 Bowers Road |

| |Kittitas | |Ellensburg WA 98926-9341 |

| |Klickitat |Supervisor Contact List: | |

| |Yakima |Supervisor Contact List | |

|South Puget Sound Region |King | | |

| |Kitsap |Gretchen Murray |Department of Natural Resources |

| |Mason | |950 Farman Ave N |

| |Pierce |gretchen.murray@dnr. |Enumclaw WA 98022-0068 |

| | |Phone: (360) 802-7026 | |

| | |FAX (360) 825-1672 | |

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Human Resources Use Only

Geographic Priority: [pic] Driver’s License

1. __________ [pic] Driving Record

2. __________ [pic] 100 Certificate

3. __________ [pic] 700 Certificate

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