San Pasqual Reservation Fire Academy

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1 San Pasqual Reservation Fire Academy Applications: All applications can be ed, mailed or dropped off at the San Pasqual Reservation Fire Department Office Located at Kumeyaay Way Valley Center, Ca Monday through Friday between 8:00 a.m. and 5:00 p.m. or ed to Candidates must attach copies of all required certifications as outlined in this application package. This includes current driver s license, high school diploma or GED, transcripts, certifications, resume and any other information required to support experience, training, and education. You may also your application to: dori@sprfa.org or ghiotto@sprfa.org Acceptance: The Academy will notify all candidates who successfully pass all phases. There will be a waiting list established. Orientation for successful candidates will be held 4 weeks before academy start date. Physical training is an important component of the Academy. All candidates must be in good physical condition before entering the Academy. Training includes calisthenics, running, aerobics, and aerobic step exercise. Candidates will be required to complete a personal history report and statement indicating freedom from physical disabilities, which would restrict physical training. Those applicants who are unable to perform typical fire fighting tasks will not be accepted into the Academy. Conduct: The Academy is run in a paramilitary fashion. Candidates are expected to adhere to strict rules of conduct. Appearance and grooming standards will be enforced. All questions regarding Academy operations and expectations will be answered during the Academy Orientation after appointment to the Academy. We look forward to your participation in the San Pasqual Reservation Fire Academy program and in helping you succeed in your Firefighter Career. Payments: All payments will be in the form of cash, cashier's check, money order, or credit card.

2 San Pasqual Reservation Fire Academy Dear Fire Academy Applicant: Thank you for your interest in the San Pasqual Reservation Fire Academy. We hope this program will help you in your preparation for a career in the Fire Service. Please read this application package and all materials carefully. Incomplete application packages, or failure to comply with these procedures, may prevent your acceptance to the Academy. PROFESSIONAL CERTIFICATE The San Pasqual Reservation Fire Academy allows the candidate to work as a Fire Fighter in compliance with State Fire Marshal and IFSAC standards. MINIMUM REQUIREMENTS: Minimum age 18 years High School Diploma or GED Valid Driver s License Candidates must also successfully complete the Academy application and an oral interview if required. SCHEDULE The San Pasqual Reservation Fire Academy is offered in a condensed 14 week format Monday Saturday from The entire program is 624 hours including an extensive physical fitness program. Class locations will be at San Pasqual Reservation Fire Department and other training facilities. EXPENSES The Fire Academy participants can expect to pay $4, for tuition (cost covers Tuition, gear, books, certifications. $1, for Barracks, $ for Facility Fee. There will be an additional charge for uniforms. The students will provide their own uniforms. Academy Class Dates: Please initial box Academy 28 - Orientation: April 25, 2016 Start: May 23, 2016 Graduation: August 27, 2016 Academy 29 - Orientation: August 8, 2016 Start: September 6, 2016 Graduation: December 10, 2016 Academy 30 - Orientation: November 28, 2016 Start: January 9, 2017 Graduation: April 15, 2017

3 San Pasqual Reservation Fire Academy Personal Data: Name: (First, Middle, Last) Home Phone: Mailing Address:(Number & Street) Cell Phone: (City, State, Zip) Address: Date of Birth: Driver s License: (Type, Number, Expiration Date) Education High School Graduate: High School: (Name & Address) Yes No GED Schools Attended Location Course of Study Units Degree or Certificate Describe additional course or training including military, which may assist you in the Fire Service: List special certificates or other competencies, which may assist you in the Fire Service: Physical Conditions or limitations Do you have any limitations that would prevent you from performing tasks involving in the Fire Academy? Yes No If yes please explain:

4 Conviction Record Have you ever been convicted of a Felony Offence, which resulted in you being imprisoned or placed on probation? Yes NO If yes please explain: Work Experience List all experiences, paid and voluntary, related to the Fire Technology Field. (List your most recent employer first.) Name of Employer: Address of Employer:(Number & Street) Title of Position: Duties: Reason for Leaving: (City, State, Zip ) Name of Employer: Address of Employer:(Number & Street) Title of Position: Duties: Reason for Leaving: (City, State, Zip ) Name of Employer: Address of Employer:(Number & Street) Title of Position: Duties: Reason for Leaving (City, State, Zip ) Certification of Application I certify that the information is true, complete, and correct. I understand that any misrepresentation or omission of facts are Caused for rejection of application and removal from eligibility list of enrollment in the Fire Academy. I hereby authorize the San Pasqual Reservation Fire Fighter I Academy Coordinator to investigate all statements in application. Signature: Mail applications to: San Pasqual Reservation Fire Academy Attention: Dori Villalobos- Muniz / dori@sprfa.org Kumeyaay Way Valley Center, Ca 92082

5 Citizenship and Ethnicity Citizenship (check only one) U.S. Citizen Permanent Resident Temporary Resident Refugee/ Asylee Student Visa (F-1 or M-1) Other Visa - specify type: Other Status INS Number ( if permanent or temporary resident) Date of Issue Expiration Date County of Citizenship (if not U.S. Citizen) County of Birth (if not U.S. Citizen) Ethnicity (Mark All That Apply) Asian: Cambodian Central American Filipino America Indian Asian: Chinese Mexican, Chicano, or Pacific Islander: Guamanian Alaskan Native Asian: Japanese Mexican-American Pacific Islander: Hawaiian White Non-Hispanic Asian: Korean South American Pacific Islander: Samoan Other Non-White Asian: Laotian Hispanic: Other Pacific Islander: Other unknown or Decline to state Asian: Vietnamese African- American Non-Hispanic Asian: Other Military Information Military Status: Currently Active military Dependant spouse or child of currently active military Currently in Reserves Currently in National Guard Discharged within the last year (veteran) Discharged over a year ago (veteran) None apply to me- skip remainder of military status questions Date of Discharge (if applicable) Military State of Legal Residence: Home of Record: Are you currently stationed in California? Yes No

6 We have a NO REFUND policy no exceptions. All monies paid to the San Pasqual Reservation Fire Department will NOT be refunded. Our policies are that you as a cadet will have one (1) year calendar to date to come to any of the next academies, we feel this allows sufficient time to get your needs in order. I am grateful for the business you have seen fit to give our Academy and am proud to have you as one of our cadets, I cannot, however, authorize the return of any monies paid to the San Pasqual Reservation Fire Academy. Due to recruitment issues, I hope you will understand why we must take this action. Cadet Date Academy Coordinator Date NOTE: San Pasqual Reservation Fire Academy does not meet Federal Regulations for IRS deductions, tax form 1098T

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