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Personal Information
* First Name
* Last Name
* Address
Address 2
* City
* State
* Zip
* Home Phone
Cell Phone
* Email
* DOB
* Gender
 
Experience/Certifications
* Employer
* Position
* Time at job

Check any certifications
you have


EMT-Basic
Paramedic
Firefighter I

Other qualifications or experience
you have that better qualifies you:
Additional Information
Tell us about any hobbies/interests etc.

* Referred by 

Please Specify

* Select the department(s) that you would
like to submit your application to:
Cameron Park (Must live in district)
Diamond Springs
El Dorado County  
El Dorado Hills (Must live in district)
George Town  
Latrobe  
Pioneer  
Rescue  
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