Citizens Fire Academy Application

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2018 Application

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

1
Name
 *
Name
2
Phone Number
 *
3
Email Address
 *
4
Address
 *
Address
5
Date of Birth (mm/dd/yyyy)
 *
6
Sex
 *
Sex
7
Driver's License or State Issued ID Number
 *
8
Occupation
9
Business Phone Number
10
Please read the program description. Can you perform the activities in the program description without an accommodation?
 *
Please read the program description. Can you perform the activities in the program description without an accommodation?
11
Please list any relatives or close friends working at Odessa Fire Rescue
12
Have you ever been arrested for any offense other than a traffic violation and/or convicted of a felony or misdemeanor?
 *
Have you ever been arrested for any offense other than a traffic violation and/or convicted of a felony or misdemeanor?
13
I hereby authorize Odessa Fire Rescue to make an examination of the records of the Odessa Police Department for the purpose of evaluating my application
 *
14
Please select your shirt size
 *
15
Shoe Size
 *
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