Online Application Step 1 of 7 14% Application Information and ChecklistTypical Membership Process Submit a fully completed application. Attend an interview. You will attend and complete KCR recruit training that will include, but not limited to: training in emergency driving, vehicle extrication, CPR, First Responder (if not currently medically certified), FEMA Incident Command, bloodborne pathogens, communications, and patient documentation.Application for MembershipKnox County Rescue does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, gender, marital status, national origin, disability or handicap, veteran status, or any other protected status.I am interested in joining the:* Water/Dive Team USAR Team Cave/Vertical Team Rehab/Support Team General Membership Personal DataLegal Name* First Last Preferred to be called:Permanent Home Address:* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Cell PhoneIf different than Home PhoneEmail* Are you 18 years of age?*YesNoDate of Birth* Date Format: MM slash DD slash YYYY Are you now serving, or have you ever served in the Military?* YES NO Branch of Military* Air Force Army Marines Navy Status* Currently Serving Discharged Years of Service*What is your component?* Active Reserve National Guard Please upload DD214*You must be 18 years of age or older to apply to be a Shift Qualified Trainee. If under the age of 18, please fill out the Cadet Application. Medical CertificationsPlease list any EMT/Rescue related skills, certifications, or professional experience that you have:Have you ever been an applicant to or a member of any other Fire/Rescue Agency?*YesNoIf so, location and dates of application or membership:Your agency and reporting officer's name: Record of ConvictionHave you ever been convicted of a crime other than a minor traffic offense?*YesNoList any criminal charges that have been brought against you, except those that have resulted ín a finding of not guilty or a complaint dismissal.A conviction will not necessarily automatically disqualify you for membership. The background check will be reviewed by KCR Board.REQUIRED https://knoxsheriff.org/support-services/ This link will take you to the Knox County Sheriff's Office Arrest Record Release Form. Go to the bottom of the page, click on Background Reports, and then download the form to complete. This form should be notarized if you do not plan to appear in person for the check. Education HistoryDid you complete high school?* Yes, have HS Diploma No, have GED No, and do not have GED check oneList Any College Degrees Earned:Other training or degrees: Employment HistoryPlease list your most recent employer. If no employment history, please list N/A in the fields.Date From:* Date Format: MM slash DD slash YYYY Date To:* Date Format: MM slash DD slash YYYY Position:*Employer:*DepartmentAddress:*Phone*Supervisor*Weekly Hours**Full TimePart TImeDuties*Reason for leaving if no longer employed Social Media PolicyKnoxville Volunteer Emergency Rescue Squad understands that some employees and volunteers participate in social networking sites (e.g. Facebook, Twitter, YouTube, LinkedIn, etc) and chat rooms, and create and maintain personal websites, including blogs. Knoxville Volunteer Emergency Rescue Squad respects employees’ and volunteers’ online social networking and personal Internet use. However, your online presence can affect Knoxville Volunteer Emergency Rescue Squad as your words, images, posts, and comments can reflect or be attributed to Knoxville Volunteer Emergency Rescue Squad. As a Team Member, you should be mindful to use electronic media, even on your own personal time, responsibly and respectfully to others. Because employees’ and volunteers’ online comments and postings can impact Knoxville Volunteer Emergency Rescue Squad and/or the way employees and volunteers are spending their time at work/duty, Knoxville Volunteer Emergency Rescue Squad has adopted the following guidelines that employees and volunteers must observe when participating in social networking sites and/or engaging in other forms of Internet use on and off duty. It shall be considered a breach of acceptable Team Member conduct to post on any public or private website or other forum, including but not limited to discussion lists, newsgroups, listservs, blogs, information sharing sites, social media sites, social or business networking sites such as LinkedIn, Facebook, or chat rooms, telephone based group communications such as Twitter, or any other electronic or print communication format, any of the following: (1) Anything that may harm the goodwill or reputation of Knoxville Volunteer Emergency Rescue Squad or any disparaging information about Knoxville Volunteer Emergency Rescue Squad. (2) Any disparaging, discriminatory or harassing information concerning any customer, employee, vendor, peer, officer or other person associated with Knoxville Volunteer Emergency Rescue Squad. Knoxville Volunteer Emergency Rescue Squad’s policies prohibiting harassment apply online as well as offline. (3) Any confidential information, trade secrets, or intellectual property of Knoxville Volunteer Emergency Rescue Squad obtained during your employment or volunteering, including information relating to finances, research, development, marketing, customers, operational methods, plans and policies. (4) Any private information relating to a customer, employee, vendor, peer, officer or other person associated with Knoxville Volunteer Emergency Rescue Squad. (HIPPA applies) In compliance with applicable regulations of the Federal Trade Commission, employees and volunteers endorsing Knoxville Volunteer Emergency Rescue Squad’s products or services must disclose their employment / volunteer relationship with Knoxville Volunteer Emergency Rescue Squad and must ensure that endorsements do not contain representations that are deceptive or cannot be substantiated. Employees / volunteers must also complete internal training on the organization’s policies for acting or speaking on behalf of or representing Knoxville Volunteer Emergency Rescue Squad. If you are speaking about a job or volunteer related content or about Knoxville Volunteer Emergency Rescue Squad you must either clearly identify yourself as a Knoxville Volunteer Emergency Rescue Squad employee / volunteer, or speak in the first person and use a disclaimer to make it clear that the views expressed belong solely to you. In addition, the following statement must be used, “The opinions expressed on this site are my own and do not necessarily represent the views of Knoxville Volunteer Emergency Rescue Squad.” DO NOT claim authorship of something that is not yours. If you are using another party’s content, make certain they are credited for it in your post and they approve of you utilizing their content. Do not use the copyrighted material, trademarks, publicity rights, or other rights of others without the necessary permissions of the rights holder(s). This Policy applies regardless of where or when employees and volunteers post or communicate information online. It applies to posting and online activity at work, home or other location and while on duty and off duty. Knoxville Volunteer Emergency Rescue Squad reserves the right to monitor and access any information or data that is created or stored using Knoxville Volunteer Emergency Rescue Squad’s technology, equipment or electronic systems, including without limitation, e-mails, internet usage, hard drives and other stored, transmitted or received information. Employees and volunteers should have no expectation of privacy in any information or data (i) placed on any Knoxville Volunteer Emergency Rescue Squad computer or computer-related system or (ii) viewed, created, sent, received or stored on any Knoxville Volunteer Emergency Rescue Squad computer or computer-related system, including, without limitation, electronic communications or internet usage. Please remember, the internet is permanent. Employees and volunteers who violate Knoxville Volunteer Emergency Rescue Squad‘s Social Networking Policy will be subject to disciplinary action, up to and including termination of the relationship.Acceptance* By Checking this box, you certify that you have read and agree to the Social Media Policy. How did you hear about Knox County Rescue?*FriendFamily MemberRescue Squad MemberVolunteer Knoxville ExpoFacebookTVOtherRescue Member's Name* Applicant's Certification & AgreementI hereby certify that the facts set forth in the above application are true and complete to the best of my knowledge. I authorize the Knox County Rescue and its Officers to verify their accuracy and to obtain reference information by contacting educational institutions, references or employers and past employers, and current or former fire and rescue agencies, and to rely on and use such information as they see fit. l hereby release the Knox County Rescue, its Officers, Directors, and assignees from any and all liability of whatever kind and nature which, at any time, could result from obtaining and having a membership decision based on such information. This application and all information obtained is the property of the Knox County Rescue. I understand that, if granted membership, falsified statements of any kind or omissions of facts on this application, regardless of time o f discovery, shall be considered sufficient basis for dismissal. I understand that should an offer of membership be extended to me and accepted that I will fully adhere to the policies, rules, chain of command, and regulations of KCR. I further understand, however, that neither the policies, rules, regulations of membership nor anything said during the application and interview process shall be deemed to constitute the terms of an implied contract for continued membership. I understand that any membership is for an indefinite duration and is at will and that either I or KCR may terminate my membership at any time with or Without notice or cause. I understand that if I am offered membership, membership is conditioned upon my providing such other and further information as may be required by the Membership Committee, Medical Committee Review, Training Committee, and/or the Board of Directors and Executive Director. I also understand that if I am arrested during my membership that information of such arrest will be immediately reported to the Executive Director and subject to review by the Board Safety Committee.* I have read and understood the terms of this page. Name of Applicant: First Last Applicant SignatureDate:* Date Format: MM slash DD slash YYYY This application is valid for 30 days from the date received. File Δ Share this:TwitterFacebookLinkedInEmail
