Page 1 of 8 Revised June 2024 LOWER VALLEY FIRE PROTECTION DISTRICT P.O. Box 520 - 168 North Mesa Street Fruita, CO 81521 -0520 Telephone: (970) 858 -3133 Lowervalleyfire. com ***** Retain page s 1-3 for your reference***** The Lower Valley Fire Protection District is an all-hazards emergency response agency that serves a 408 square mile district. The district is made up of career and part -time staffing (see below for position requirements) . The district accepts applications year -round for part-time positions and holds a candidate testing to fill positions for the recruit academy . Applications for career positions are only accepted during specific times as vacancies occur. The candidate testing process is a multi -component progressive process and the candidate must pass each component to progress to the next step. The process begins with review of the application, previous employer, and reference verification. The candidate will then be scheduled for the Physical Ability Test (see page 2 for further), skills assessment and Officer Interview. A suitable candidate will then be recommended to the Fire Chief who will schedule a Chief Interview. Following the Chief Interview, the successful candidate will receive a conditional offer at which time a criminal background check, drug screen, and pre-employment medical physical must be completed prior to beginning work. Position Qualification (all applicants): Applicant must be a citizen of the United States of America and at least 18 -years of age. Applicant must possess a high school diploma or GED equivalent prior to applying. Applicant must have a valid Colorado driver’s license. Applicant shall be examined and certified by a physician for firefighting and emergency medical duties. Applicant shall be in sound physical health and mentally fit to perform firefighting and emergency medical duties. Applicant shall pass a physical agility test and an oral interview. Applicant m ust pass a background check and drug screening. Part-time: Applicant must have a current EMT, or high, certification. Applicant will be required to successfully complete Recruit Academy (unless applicant already possesses minimum certification). Applicant will be required to obtain additional minimum certifications (Firefighter I, Hazardous Materials Operation, NIMS 700 & 800, IS - 100 &200, S -130 &S -190) within two years of hire. Applicant will be required to maintain a minimum of 24 hours with a maximum of 72 hours per two week pay period . Part-time positions will receive $14.42/ HR until minimum certifications are obtained. Lateral applicants will receive $20/ HR BLS and $25/ HR ALS. Career: Refer to Open Position Announcement for specific requirement and compensation. Page 2 of 8 Revised June 2024 Lower Valley Fire District Candidate Physical Ability Test Lower Valley Fire District Candidate Physical Ability Test Purpose: Identify and explain the process of physical ability testing . Candidates must always wear all PPE during the test. Candidates will have the ability to walk through the test and ask questions with the group and ask questions as needed. Candidates will have a minimum of one proctor accompany/ observ ing test during all part s. The test will be administered as a pass or fail with a 7-minute time limit. If at any time the candidate’s health or safety becomes endangered the proctor will stop the test. All candidates will have the ability to retake the test one time. The test consists of 5 stations. All stations must be completed in order and some stations will have automatic fail criteria. A maximum of two warnings per station will be allowed. After two warnings the testing will stop, and the candidate will fail . If the candidate exceeds the time allowed, he/she will fail the test. Vital signs will be taken prior to and posttest . PPE Issued: Candidate will don 45lbs weight vest. Leather gloves will be always worn . A fire helmet and eye protection will be required. Candidate supplied: Candidate will wear long pants and closed toe/ heel shoes. Station 1 Stair Climb Location: In the North stair well of the fire station. Process: Candidate will have all PPE on, and test time will begin when candidate’s foot touches first step. Candidate will carry a 2 1 /2” hose pack throughout the stair climb. Candidate will ascend the stairs , touch ing each stair with at least one foot. NO RUNNING is permitted. Candidates are allowed to use handrails at any time. When candidate reaches the top landing , they will touch the door then descending back down touching each step to bottom landing. At top and bottom landing s, the candidate will place both hands on the wall before returning to the stairs . Candidate will perform two ascending stairs and two descending stairs before proceeding to station two. Warnings: Candidate running, candidate missing stairs, candidate not placing both feet on landing before proceeding to stairs. Station 2 Farmer’s Carry & Hose Hoist Location: Upstairs hallway to South stair well bottom landing . Process : After completing station one candidate will walk down the hallway carrying two five-gallon buckets with 35lbs in each hand. Candidate will set the buckets down at the end of the hallway before proceeding down the stairs. Candidate will hoist a rolled 50 foot 2 ½ hose line up to landing then lower hose back to the ground floor , hose must touch the ground. At NO TIME should the rope slide through the hands of the candidate. Warnings: Rope slides through hands of candidate, not raising hose roll to touch bottom of pulley, not touching ground when lowering hose roll . Automatic Fail: Dropping the hose roll at any time . Station 3 Force Sled Location: South stair well . Process: Candidate will step onto sled and will be handed a dead blow hammer. Candidate will use the hammer to move the weighted sled to match the color line. Candidate will stand with one leg on each side of sled. Candidate will hit the sled squarely with each hit until the sled reaches the line. Candidates may stop and take breaks as needed. Candidate must always have both hands on the hammer . When weight reaches the same color line the station is completed, and candidate will walk to the next station. Candidate will incur warnings if he /she runs between stations. Warnings: Candidate does not keep feet on both sides of sled; candidate loses contact with hammer with one hand . Page 3 of 8 Revised June 2024 Automatic fail: Candidate loses contact with hammer with both hands. Station 4 Hose Drag Location: Outside a pparatus bays . Process: At the first cone , a nozzle connected to 1 ¾ charged hand line will be found. Candidate will pick up the nozzle and place it in a position of comfort . Candidate will drag the hose 100 feet to the second cone. Candidate must always maintain control of nozzle . Candidates are not allowed to touch any more than the first 4 feet of the hose line which will be marked by tape. Candidate must drag the hose in a forward motion. Candidates are not allowed to run but may move with purpose. Warnings: Candidate running, candidate drops nozzle, candidate moves in a backwards direction, candidate drags hose too far past mark. Station 5 Rescue Drag Location : Apparatus bay Process: At the first cone a 185lbs dummy will be placed in a supine potion. Candidate must approach the dummy from the head side and move the dummy from the first cone around the second cone and back past t he first co ne. Candidate may pick up the dummy under arms or drag the dummy. Candidate may not place dummy in any carry position which removes the dummy completely from the ground. The dummy must always stay in contact with the ground . Candidates will not run during the event. Candidate may set the dummy down and readjust as necessary. After the dummy’s feet pass the first cone , the physical ability test is complete, and time will stop. Warnings: The d ummy loses contact with ground, running, dropping the dummy, or improper lifting technique. Page 4 of 8 Revised June 2024 LOWER VALLEY FIRE PROTECTION DISTRICT P.O. Box 520 - 168 North Mesa Street Fruita, CO 81521 -0520 Telephone: (970) 858-3133 Lowervalleyfire. com APPLICATION FOR RESERVE/ CAREER Name: (Last) (First) (M) Present Address: City: State: Zip: Home Phone Number: ( ) Cell Phone Number: ( ) Email address: _____________________________________ Are you at least 18 years of age? Yes No Have you ever worked for this company before? Yes No Are you legally allowed to work in the United States? Yes No Type of employment desired: Full - Time Part-Time Are you currently related to, in any form - a Paid Staff Member or District Board Member? Yes No If so, please explain in full: Have you ever been arrested? Yes No If so, describe in full, when, and why: Driver’s License Number: State: Expiration Date of Driver’s License: / / Type(s) of License: Are you or have you ever had your driver’s license suspended? Yes No If so, when? If so, why? Armed Forces Service: Yes No Rank at discharge or your current ra nk: Branch of Service: Air Force Army Coast Guard Marines Navy Military Duties: Education History: Name & Location of High School Did you graduate? Yes No Name & Location of College Years attended Degrees completed Other subjects studied Page 5 of 8 Revised June 2024 Trade, Business or Corr espondence School Years attended Subjects studied Did you graduate? Yes No Previous Employment (begin with most recent) Dates of Employment: From / / To / / Position(s) Held: Name of Employer: Address: City: State: Zip Code: Phone: Supervisor: Title: May we contact employer? Yes No Responsibilities: Reason for Leaving: Dates of Employment: From / / To / / Position(s) Held: Name of Employer: Address: City: State: Zip Code: Phone: Supervisor: Title: May we contact employer? Yes No Responsibilities: Reason for Leaving: Dates of Employment: From / / To / / Position(s) Held: Name of Employer: Address: City: State: Zip Code: Phone: Supervisor: Title: May we contact employer? Yes No Responsibilities: Reason for Leaving: Summarize You Special Skills or Qualifications : ___________________________________________ _________________________________________________________ Page 6 of 8 Revised June 2024 Personal References (non - relatives): Name: Years Known: How Do You Know This Person? Phone: Email: Name: Years Known: How Do You Know This Person? Phone: Email: Name: Years Known: How Do You Know This Person? Phone: Email: “I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements containe d herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result f rom utilization of such information. I also understand and agree that no representative of the company has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is i n writing and signed by an authorized company representative. This waiver does not permit the release or use of disability -related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.” I understand I need to obtain a copy of my driving record from the Division of Motor Vehicle and that I am to have that copy attached to this application at the time of submitting my application. This can be obtained in person from the local office or for more information go on-line at: www.colorado.gov/cs/Satellite/Revenue -MV/RMV/1187080331197 then go to Frequently Asked Questions, then Getting Driving Record: My Own/Others? There is usually a small fee for this. I understand if my application is accepted, I agree that I will comply with all confidentiality policies and procedures set i n place by Lower Valley Fire District and know that any patient information will not be discussed outside of the department. I have read and discussed, and fully understand the above conditions and agree to the conditions as stated. Date: _____/_____/_____ Signature of Applicant: Check List for Required Attachments: [] Copy of Colorado Driver License [] Colorado Driving Record [] Copy of High School Diploma/GED [] Copy of EMT/ Paramedic Certification (if applicable) [] Copy of CPR, ACLS, PALS Certification (if applicable) [] Copy of all Fire & HazMat Related Certification (if applicable) [] Immunization Record to Include: [] Hepatitis B Series (or titer) [] MMR and TDAP (tetanus within 7 -10 years , diphth eria, pertussis/whooping cough ) [] Varicella (or titer) Page 7 of 8 Revised June 2024 AUTHORIZATION FOR RELEASE OF INFORMATION Name: Social Security Number: ________/________/________ Birth Date: / / I hereby authorize the Lower Valley Fire Protection District to investigate my past and present police records, employment records, education, character, credit and medical background to ascertain any and all information which may have a bearing on my application for part-time or full-time employment. The release of all information is authorized whether same is of record or not, and I do hereby release all persons, cities, firms, agencies, companies, districts, groups or installation whomsoever, from any damages because of/or resulting from furnishings such information to the Lower Valley Fire Protection District/representatives of Fruita, Colorado. This release will expire 365 days after the date signed. Fruita, Colorad o ________/________/________ (Date ) Signature _____________________________________________ (Signature ) Subscribed and sworn to before me this _________ day of , 20________ Notary Public My Commission Expires ________/________/________ State of Colorado ) ) ss County of Mesa ) ========================================================================================== This section below for Lower Valley Fire District Use Only: Date application was receiv ed in office: ________________________ Physical Agility Test Completed – Date: __________________ _____ Oral Interview Completed – Date: ____________________ ________ If passed, Chief’s Interview - Date : Applicant Eligible for Hire: Yes No If No, Reason: Actual Hire Date : __________________ Eligible for rehire : Yes No If No, Reason: Page 8 of 8 Revised June 2024 WAIVER OF LIABILITY The Lower Valley Fire Protection District, agents, employees, volunteers, Board of Directors, or any representative thereof are not responsible for any injury, loss or damage from any cause whatsoever that may be suffered by participating in an agility testing as part of qualification for a position within the district . Applicant releases the Lower Valley Fire Protection District and its staff, agents, and/or individuals and employees for such injury, loss or damage. No responsibility is assumed by the Lower Valley Fire Protection District, its agents, employees for goods delivered to the site or for items left on premises before, during or after the testing. I, as an applicant, agree to this Waiver of Liability and sign with that understanding. APPLICANTS SIGNATURE DATE DISTRICT REPRESENTATIVE
