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2. First Name*
3. Last Name*
5. Date*
   Date
7. Have you applied online and submitted a resume at https://www.mountvernonwa.gov/Jobs.aspx*

   1. Yes
   2. No
9. Have you applied through NTN at https://www.nationaltestingnetwork.com/publicsafetyjobs/*

   1. Yes
   2. No
11. Are you a U.S. citizen?*

    1. Yes
    2. No
13. Are you 21 years of age or older?*

    1. Yes
    2. No
15. Do you possess a Washington State EMT / Paramedic Certification, National Registry or other state equivalency with the ability to be certified in Washington?*

    1. Yes
    2. No
17. Do you possess a Firefighter 1 certification or have the ability to obtain upon completion of the fire academy?*

    1. Yes
    2. No
19. Do you possess a valid CPAT, or have the ability to obtain by date of hire?*

    1. Yes
    2. No
21. Have you graduated from high school or obtained a GED?*

    1. Yes
    2. No
23. Do you have a valid Washington State Driver's license or the ability to obtain one by the date of hire?*

    1. Yes
    2. No
25. Do you have 90 quarter credit hours of general course studies from an accredited college or university?*

    1. Yes
    2. No
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27. 1. Receive an email copy of this form.
28. Email address

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29. Submit

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