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Join Our Department

No experience necessary. We provide the training, the gear, and the people to learn from.

Becoming a Member

How It Works

Send in an application

Fill out the form on this page, or download the printed application and drop it off at the station.
Meet with an officer

We will contact you to talk about what the department expects and answer your questions.
Background check and paperwork

Standard for every member. This is the point where we collect the remaining personal information.
Start training

You will be paired with experienced members and work toward state certification.

Prefer paper?

Download the department’s full application, print it, and bring it to the station or mail it in.

Download Application (PDF)

About the Social Security number

The printed application asks for one. This online form does not — that belongs in the background-check step, in person, once you have been screened. Nothing else is left out.

Mailing address

Killbuck Township Fire & EMS
PO Box 393, Killbuck, Ohio 44637

Membership Application

Fields marked * are required. Applicants may request reasonable accommodation in the application or interview process.

Applicant

First name *

Last name *

Street address *

City *

State

ZIP *

Telephone *

Email *

Date available to start

Veteran?

Branch of service

Legally permitted to work in the United States? *

Background

Have you previously applied with Killbuck Township Fire & EMS?

If so, when?

Are you related to anyone currently on the department?

If so, name and relationship

Any time commitments that may interfere?

If yes, please explain

Able to perform the essential functions of the position, with or without reasonable accommodation?

Have you ever been dismissed from or asked to resign from a position?

If yes, please explain

May we contact your present and past employers for a reference?

Describe briefly the type of work you are best qualified to do, and why you feel qualified

Driving Record

Valid Ohio driver’s license?

Valid Ohio commercial driver’s license (CDL)?

Licence suspended or revoked in the last three years?

Auto insurance rejected, cancelled, or high-risk?

Traffic violations in the past three years?

If yes, list each offence and approximate date

Education

Optional — you can bring this with you instead.

High school — name, location, did you graduate?

College / university — name, location, major or degree

Other schools attended

Other courses or special training (fire, EMS, rescue)

Employment History

Last ten years, most recent first, including U.S. military if applicable. Optional — you can bring this with you instead.

Most recent employer — name, address, phone, dates, position, supervisor, reason for leaving

Previous employer

Personal References

Three people who are not relatives or former employers.

Reference 1 — name, address, telephone, occupation *

Reference 2 *

Reference 3

I certify that the information in this application is true and complete to the best of my knowledge, and I understand the department will contact me to complete a background check and the remaining paperwork in person. *

Join Our Department

How It Works

Send in an application

Meet with an officer

Background check and paperwork

Start training

Prefer paper?

About the Social Security number

Mailing address

Membership Application