INTERNSHIP-APPLICATION-PACKET-2025 Revised

www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department 18 Oxford Place, Madison, WI 53704 Phone: (608) 244-3390 www.villageofmaplebluff.com/fire-rescue “Serving with pride” I n t e r n s h i p P r o g r a m www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department INTERNSHIP INFORMATION Internships have long served as a vital steppingstone for individuals seeking an advantage in their chosen careers. Our internship program could be your opportunity to advance. Emergency Medical Service (EMS) has become integral to a firefighter's job requirements in today's fire service. The Maple Bluff Fire Rescue Department offers our interns fire and EMS experience. We allow our interns to receive EMS certification to the Wisconsin EMT-Intermediate Technician/Advanced EMT Level and the State of Wisconsin Firefighter II Certification while achieving your associate’s degree in Fire Science from Madison Area Technical College. Our intern firefighters/EMTs will also experience the camaraderie of living in a fire station and performing assigned duties as a team. To qualify to intern with our department, you must be enrolled in or on the waiting list for the Fire Protection Program at Madison Area Technical College. If selected, your internship will last for the duration of the associate's degree program (2 years). Our department offers four monthly training sessions (three fires and one EMS) to keep our staff trained in today's ever-changing standards. The Maple Bluff Fire Rescue Department provides financial assistance for additional training and classes. Our internship is a chance to receive the needed training, experience, and life skills to help you succeed in a fire/EMS service career. www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department MAPLE BLUFF FIRE RESCUE DEPARTMENT Maple Bluff Fire Department is a combination department with 4 full-time staff, duty officers, paid-on-call personnel, and up to 8 interns. Our apparatus comprises a command SUV, two engines, and an ambulance. Our primary response area consists of the Village of Maple Bluff. The Maple Bluff Fire Rescue Department proudly serves its 1,400 residents by providing fire suppression, fire prevention, vehicle extrication, public education, fire inspections, water/ice rescue, and emergency medical services. We also respond with neighboring departments when requested through the Mutual Aid Box Alarm System (MABAS) Division 115. Some of our mutual aid partners include the City of Madison, Deforest, Monona, Truax Field (Dane County Regional Airport), McFarland, and Waunakee Fire Departments. QUALIFICATIONS AND QUALITIES The Maple Bluff Fire Rescue Department is an equal-opportunity organization. QUALIFICATIONS/REQUIREMENTS: • be a United States citizen • be at least 18 years of age before starting Madison College Associate’s Degree Program • be a high school graduate or possess a high school equivalency diploma • Enrolled in or on the waiting list for the Fire Science Associate’s Degree Program at Madison College • possess a valid Wisconsin driver’s license • must be of good mental and physical health • pass a physical agility/written examination • pass a pre-employment medical/drug screening QUALITIES DESIRABLE IN A FIREFIGHTER/EMT: • motivation to serve • effective communication skills • good physical, mental, & emotional health • ability to exercise sound judgment • strong sense of responsibility • compassion in all situations • ability to work as a team member • honesty and integrity • good problem-solving skills • desire to work hard • sense of humor www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department APPLICATION DEADLINE Internship applications must be received by February 21st, 2025. For an applicant to be considered for the position, the following must be turned in: -Completed Application -Copy of Driver’s License -Copy of Social Security Card -Copy of Birth Certificate Completed materials can be emailed to Assistant Chief Jeff Drager (jdrager@villageofmaplebluff.com) or dropped off at our station, Maple Bluff Fire Rescue Department, 18 Oxford Place, Madison, WI 53704. INTERVIEWS Internship interviews will be held in March of 2025. JOB OFFER Internship candidates who are accepted into the program will be notified before April 5th, 2025. www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department APPLICATION FOR MEMBERSHIP (Please Print or Type) Date Application Submitted: ________________ Last Name: __________________________ First Name: ______________________ Middle Initial: ______ Address: ____________________________________________________________ City: _____________________________ State: _________ Zip Code: ___________ Home Phone: (___) _____-_______ Work Phone: (___) ____-_______ Cell Phone: (___) _____-_______ E-Mail: __________________________________________ Cell Service Provider: __________________________ How did you here about us? Friend: ___ Name: ___________________________________ Advertisement: Internet: _____ Flyer: _____ Direct Mailing: _____ School (name):_________________________ Other (describe):________________________ Date of Birth: ____/_____/_____ Social Security Number: ______-_____-______ Driver License Number: ____________________________________ State: _______ Are you at least 18 years old? Yes ____ No ____ Do you have a high school diploma or equivalent Yes ____ No ____ What High School Did You Attend? __________________________________________________ Are you currently enrolled in the Associate of Fire Science Program at MATC? Yes ____ No ____ Are you prevented from lawfully becoming employed? in this country due to visa or immigration status? Yes ____ No ____ If yes explain? ____________________________________________________________________ www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department Have you been convicted of a felony? Yes ____ No ____ If yes, explain. _____________________________________________________________________________ Current Employer: ___________________________ Dates Employed: _______ to _______ Address: ___________________________________ Phone number: (____) _____ -______ Job Title: _______________________ Supervisor: _________________________________ May we contact your employer? Yes____ No_____ Previous Employer: ___________________________ Dates Employed: ______ to _______ Address: ___________________________________ Phone number: (____) _____ -______ Job Title: _______________________ Supervisor: _________________________________ May we contact your employer? Yes____ No_____ (Attach additional sheets if needed. You need only list your past five years of employment) (Applicants may include a resume, however this is optional) List Any Specialized Training, Certifications, License, or Skills. (first-aid, CPR, etc.) _________________________________________________________________________________ _________________________________________________________________________________ ______________________________________________________________________________ List Any Previous Fire/EMS Service Experience (not required): Department Name: ___________________________ Years Served: ___________________ Rank/Position: ________________ Supervisors Name: ___________________________ Phone # (____) _____-________ If not selected as an intern, are you interested in volunteering with our department? Yes____ No____ www.villageofmaplebluff.com Phone: 608.244.3390 18 Oxford Place Madison, WI 53704 Maple Bluff Fire Rescue Department APPLICANT’S STATEMENT I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation/background checks through the Police Department, State, FBI, or any other recognized organization. I understand and agree that I may be required to take a physical examination as a condition of employment/ membership. In the event of employment/ membership, I understand th at false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer/ membership. ________________________________ __________________ Signature of Applicant Date