Fire Fighter / First Responder Employment Application You must also submit the Applicant Release Form found by clicking here. Name *Driver's License Number *Street Address *Apartment, suite, etcCity or Township *Date of birth (if under 18 years of age)Home PhoneWork PhoneWhat position are you applying for? *Do you have Firefighter experience? *YesNoDo you have Medical First Responder experience? *YesNoEmployerEmployer Street AddressApartment, suite, etcCityState/ProvinceZIPNormal work hoursDo you agree to have a physical exam? *YesNoCan you leave work? *YesNoDo you agree to a driving record check? *YesNoDo you work weekends? *YesNoDo you agree to a criminal history check? *YesNoEmergency ContactEmergency Contact PhonePhysician's NamePhysician's PhoneDistance from your home to your assigned stationState your reasons for applying for membership in the Sparta Fire DepartmentPlease list any impairments that would prevent you from performing fire department duties. Submit ApplicationPlease do not fill in this field.