Victoria Fire Department Fire Academy Application

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Fire Academy Application

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

Personal Information

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First Name:
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Last Name:
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Address 1:
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Address 2:
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City:
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State:
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Zip Code:
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Primary Phone Number:
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Secondary Phone Number:
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Email:

Voluntary Demographic Data

THIS INFORMATION IS STRICTLY VOLUNTARY. The information given is used for statistical reporting to various regulatory agencies. This information will in no way be used in consideration of your application.

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Gender:
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Hispanic/Latino
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Racial Designation:

Education

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Did you graduate high school? Yes or No.
 *
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List High School name and address
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Did you achieve a GED? Yes or No.

Supplemental Questions

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Are you 18 or older? Yes or No.
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Do you have a High School Diploma or GED? Yes or No.
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Do you possess a TDSHS EMT Certification? Yes or No.

Certification

This is a government document. Submission of false information on a government document is a crime. I certify that all the information provided by me in connection with my academy application, whether on the document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information shall be grounds for refusal to admit or, if admitted, discharge from the academy. The City of Victoria does not discriminate on the basis of race, religion, color, age, gender, sexual orientation, national origin, disability or military status.

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I certify that I have read and agree with these statements.
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Name:
 *
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Date:
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Please upload copies of the following documents with the application:
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Texas DSHS EMS Certification
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High School Diploma or G.E.D.
 *
  1. To receive a copy of your submission, please fill out your email address below and submit.