Villa Hills Fire Department | St. Clair County, Illinois

Personal Information

All fields are required unless noted.

First Name *

Last Name *

Date of Birth *

Phone Number *

Email Address *

Street Address *

City *

State *

ZIP Code *

General Qualifications

Have you completed a Basic Operations Firefighter course through the State of Illinois? *

YesNoCurrently enrolled

Are you available to attend Monday night training sessions on a regular basis? *

YesNoMost of the time

Military Service

Villa Hills Fire Protection District proudly welcomes veterans.

Have you served in or are you currently serving in the United States Armed Forces? *

Yes — VeteranYes — Currently ServingNo

Medical Credentials

Illinois licensed medical providers only.

Are you a licensed First Responder, EMT, or Paramedic through the State of Illinois? *

YesNo

Background Information

Answer all questions honestly. A conviction does not automatically disqualify an applicant.

Have you ever been convicted of a misdemeanor? *

YesNo

Have you ever been convicted of a felony? *

YesNo

Have you ever been convicted of any offense involving moral turpitude? *

Moral turpitude offenses generally include crimes involving dishonesty, fraud, theft, or conduct contrary to community standards of justice.

YesNo

Certification & Signature

I certify that all information provided in this application is true and complete to the best of my knowledge. I understand that any misrepresentation or omission of facts may result in disqualification from consideration or, if discovered after appointment, may be grounds for dismissal. I authorize Villa Hills Fire Protection District to conduct any investigation necessary to verify the information provided.

Electronic Signature (Type full legal name) *

Date *

Volunteer Application

Personal Information

General Qualifications

Military Service

Medical Credentials

Background Information

Certification & Signature