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#17-8137-01
Supplemental Questionnaire

Last Name
First Name
 

Thank you for your interest in the position of Firefighter Recruit.  Applicants for this positon are required to submit responses to the following supplemental questions.  Your completed responses to the supplemental Questionnaire will be evaluated to determine your qualifications and must be completed properly in order to be given full consideration for the next phase in the selection process.


You MUST upload copies of the certification/licenses to your FCTC profile by the last date of filing, May 26, 2017.
Please do not upload any documents to your Alameda County Application.
Late Submissions will not be accepted.

Alameda County will be receiving FCTC’s Statewide Eligibility List, which will have confirmation of the following candidate information:
• Is 18 years of age or older
• Possesses a valid California driver’s license
• Has a high school diploma, GED or any higher level degree
• Possesses a valid Cal- JAC CPAT within the last twelve months from the last day of filing
• Receives a passing score of 70% or above on the FCTC Written Test
• Has California EMT certification active and unrestricted by the last day for filing of the application –Must have an EMT or AEMT certification
• California Paramedic License active and unrestricted by the last day for filing of the application if applicable 

For Questions regarding the FCTC Statewide eligibility list, please call 1-877-648-2728

By selecting yes below, you acknowledge understanding of the information noted above.
  

 

Yes No
1

Did you graduate from high school or possess an acceptable equivalency certificate, such as the General Educational Development Certificate (State of California), or any higher level degree from an accrediated college or university?

Yes No

 

LICENSE


2

Do you have a valid California Emergency Medical Technician (EMT or AEMT) Certificate or California Paramedic License active and unrestricted.  Must be valid by the last day for filing of the application. 

Yes No
3

Please check all that apply.  IF NONE ARE CHECKED, IT WILL BE ASSUMED THAT YOU DO NOT POSSESS ANY OF THESE AND YOU WILL BE DISQUALIFIED.

Emergency Medical Technician (EMT) Certificate
Emergency Medical Techncian (AEMT) Certificate
Paramedic License (EMT-P)
4

Do you possess a Candidate Physical Ability Test (CPAT) certificate issued within the last twelve months from the last day of filing?

Yes No
5

Do you possess a valid California State Motor Vehicle Operator’s License?

Yes No

 

SPECIAL REQUIREMENTS


6

Are you at least 18 years of age?

Yes No
7

The following Special Requirements are also needed to meet the Minimum Qualifications:

Being able to successfully pass a thorough background investigation, medical examination (NFPA 1582) and psychological examination.
Must be eligible to obtain a Department of Energy security clearance.
Those hired as firefighter-paramedics must be able to successfully obtain Alameda County Paramedic accreditation (EMSA Policy 2000).
To the best of your knowledge, do you believe you would meet these Special Requirements needed to meet the Minimum Qualifications?

 

 

 

Yes No

 

The following questions are being asked to determine if you possess any of the "Desirable Qualifications".  A response of "NO" in this area is not disqualifying.

 

 

 

 


8

Will you have successfully completed the California State Fire Marshal approved Firefighter I course by the last day of filing?

Yes No
9

Do you have current experience in the Alameda County Fire Department Reserve Program or in a similar program sponsored by a municipal fire agency?

Yes No
9a

If Yes, Please Check All the Apply.

I have current experience in the Alameda County Fire Department Reserve Program
I have current experience in a similar program sponsored by a municipal fire agency
I do not have current experience in Alameda County Fire Department Reserve Program or in a similar program sponsored by a municipal fire agency.
 

If your current expereince is in a similar program sponsored by a municipal fire agency, please list the agency.


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