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Join Our Team

Please fill out the application below

Step 1 of 3

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Applicant Information

Name(Required)

First M.I. Last

Date of Birth(Required)

Address(Required)

Street Address Apartment/Unit # City State ZIP Code

Phone(Required)

Email(Required)

Drivers License #(Required)

State(Required)

Expiration Date(Required)

Position Applied For(Required)

Are You a Citizen of the United States?(Required)

Yes

No

PSID #(Required)

Have You Ever Applied for a Position Here?(Required)

Yes

No

If Yes, When?(Required)

Have you been convicted of a felony?(Required)

Yes

No

If yes, explain:(Required)

Type of Employment Requested(Required)

Full Time

Part Time

Education

High School(Required)

High School Address(Required)

Street Address Address Line 2 City State ZIP Code

From(Required)

To(Required)

Did you graduate?(Required)

Yes

No

Diploma(Required)

Did you attend a college?(Required)

Yes

No

College Attended(Required)

College Address(Required)

Street Address Address Line 2 City State ZIP Code

From(Required)

To(Required)

Did you graduate?(Required)

Yes

No

Degree(s)(Required)

Other Education

Other Education Address

Street Address Address Line 2 City State ZIP Code

From

To

Did you graduate?

Yes

No

Degree(s)

References

Please list three personal references, not related to you.

Full Name(Required)

First Last

Years known(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Full Name(Required)

First Last

Years known(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Full Name(Required)

First Last

Years known(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Current Employment

Are You Currently Employed?(Required)

Yes

No

Company(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Supervisor Name(Required)

First Last

Job Title(Required)

Starting Salary(Required)

Ending Salary(Required)

Responsibilities(Required)

From(Required)

To(Required)

Reason for leaving(Required)

May we contact your previous supervisor for a reference?(Required)

Yes

No

Previous Employment

Do You have a previous employment to share?(Required)

Yes

No

Company(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Supervisor(Required)

First Last

Job Title(Required)

Starting Salary(Required)

Ending Salary(Required)

Responsibilities(Required)

From(Required)

From(Required)

Reason for leaving(Required)

May we contact your previous supervisor for a reference?(Required)

Yes

No

Previous Employment cont.

Any other employment to share?(Required)

Yes

No

Company(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Supervisor(Required)

First Last

Job Title(Required)

Starting Salary(Required)

Ending Salary(Required)

Responsibilities(Required)

From(Required)

To(Required)

Reason for leaving(Required)

May we contact your previous supervisor for a reference?(Required)

Yes

No

Military Service

Military service?(Required)

Yes

No

Branch(Required)

From(Required)

From(Required)

Rank at Discharge(Required)

Type of Discharge(Required)

If other than honorable, explain:(Required)

Certifications

Are you Firefighter I/II Certified?(Required)

Yes

No

Are you EMT-B Certified?(Required)

Yes

No

Paramedic?(Required)

Yes

No

List any additional applicable certifications:

Disclaimer and Signature

I, the undersigned, certify the information contained on this document to be true to the best of my knowledge. I understand that efforts will be made to verify the information. I further understand that falsification of information may result in elimination from further consideration for employment. If falsification herein is discovered after employment with the Mooresville Fire Department, it may result in termination of that employment.

Signature(Required)

Date(Required)

Contact Us

Phone Numbers

Headquarters - (317) 831-5354
Fax: (317) 831-9542

Station 1 - (317) 834-4386

Offices

Headquarters
26 S Indiana St., Mooresville, IN 46158

Station 1
415 E State Road 144, Mooresville, IN 46158

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