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2. First Name:*
4. Last Name*
6. Student ID #*
8. Cell Phone number*
10. Email Address*
12. School Address*
14. Home Address*
16. Current Schooling*

    1. University of Massachusetts Amherst
    2. Amherst College
    3. Hampshire College
    4. Other
18. How many semesters do you have remaining*
    -- Select One --12345678

    We generally only accept students with four semesters or more left.
20. Current GPA
    A 2.5 is required to join the engine company.
22. Fire Service Experience*
    Do you have any experience in the fire service? If so, please describe it in a brief paragraph. Otherwise, answer "N/A."
24. Emergency Medical Service Experience*
    Do you have any EMS experience? If so, please describe in a brief paragraph. Otherwise, answer "N/A."
26. Employment Experience #1*
    Please provide a brief summary of one place you have worked and what your duties were.
28. Employment Experience #2
    Please provide a brief summary of one place you have worked and what your duties were.
30. Other
    Please provide any other information about yourself that you believe would be helpful for us to learn about you or will set you apart from the other candidates.
32. Optional Resume
34. Important:
    You should receive a copy of your application by email if you indicate below. If you are submitting your application during our Fall or Spring recruitment drive you will be contacted soon for an interview. If you are submitting an application during other times of the year we will hold your application until our next recruitment drive and then contact you. For questions please contact us at fire@amherstma.gov or 413-259-3083.
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36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field