Fire Fighter Recruitment

Fire Department Application

<form-template>
	<fields>
		<field type="text" subtype="text" required="true" label="Name (First, Last, Initial)" class="form-control text-input" name="text-1583267889672"></field>
		<field type="date" required="true" label="Date of Birth" class="form-control calendar" name="date-1583267932433"></field>
		<field type="text" subtype="text" label="Age" class="form-control text-input" name="text-1583268305711"></field>
		<field type="text" subtype="text" required="true" label="Address (Street)" class="form-control text-input" name="text-1583267965271"></field>
		<field type="text" subtype="text" required="true" label="Town" class="form-control text-input" name="text-1583763848907"></field>
		<field type="text" subtype="text" label="Home Phone Number" class="form-control text-input" name="text-1583267981065"></field>
		<field type="text" subtype="text" required="true" label="Mobile Phone Number" class="form-control text-input" name="text-1583268045017"></field>
		<field type="text" subtype="email" required="true" label="Email" class="form-control text-input" name="text-1583268068001"></field>
		<field type="select" label="What Class of Drivers License do hold?" class="form-control select" name="select-1583449414391">
			<option value="—Select—" selected="true">—Select—</option>
			<option value="Class 1">Class 1</option>
			<option value="Class 2">Class 2</option>
			<option value="Class 3">Class 3</option>
			<option value="Class 4">Class 4</option>
			<option value="Class 5">Class 5</option>
		</field>
		<field type="select" label="Do you have the Air Brake endorsement?" class="form-control select" name="select-1583449551451">
			<option value="—Select—" selected="true">—Select—</option>
			<option value="Yes">Yes</option>
			<option value="No">No</option>
		</field>
		<field type="checkbox-group" required="true" label="Do you have a first Aid/CPR Qualification?" description="Select all that apply. " class="checkbox-group" name="checkbox-group-1583764019316">
			<option value="No qualification" selected="true">No qualification</option>
			<option value="Emergency First Aid">Emergency First Aid</option>
			<option value="Standard First Aid">Standard First Aid</option>
			<option value="CPR-C">CPR-C</option>
			<option value="MFR">MFR</option>
			<option value="EMR">EMR</option>
			<option value="EMT">EMT</option>
		</field>
	</fields>
</form-template>

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Fire Fighter Recruitment