Please complete this application form if you are interested in becoming a Fire Auxiliary Intern in the Torrance Fire Department. Once you complete the form, click the submit button at the bottom. Also, please e-mail the required documents and autobiography to Janice Tersigni at JTersigni@TorranceCA.Gov. The required documents are proof of graduation from a CA State Certified Fire Academy, proof of a CA EMT-1 Certification with LA County EMT Scope of Practice, proof of a valid CA driver's license, and proof of completing the CPAT. The autobiography should describe your education, training, experience, and why you are interested in a fire service career.


Name and address


Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.



Availability

Please indicate the days and times you are usually available to volunteer.



Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.



Assignment Preference


Training and Education


Licenses & Certifications

In the space provided below, please provide your graduation date and location of the Certified California Fire Academy that you attended. Also please provide your Los Angeles County EMT 1 Certification number.



Disclosure of Convictions

Use the space below to list any conviction, including misdemeanors. A conviction does not necessarily disqualify an applicant from service. Consideration will be given to the nature of the conviction and the time that has elapsed since the time of the conviction.



References

You must provide two references (no relatives) and provide their contact information below:



Emergency Contact

Please provide the name and contact information for the person that should be called in the event of an emergency.



Volunteer Agreement and Authorizations

I understand that the City of Torrance Fire Auxiliary Program is unpaid and that I am agreeing to perform assigned work without salary. Furthermore, I agree to comply with all City of Torrance Policies regarding the Fire Auxiliary program.


Reference Verification and Background Check: I authorize refrence and employment verification for specific positions that I have volunteered to perform. I authorize fingerprinting and criminal background checks and Department of Motor Vehicle checks as necessary for specific positions.


Photo Release: I give the City of Torrance, free of any compensation, unlimited permission to use, publish and republish, in any media now in existence and that may later be developed, for any lawful purpose as it may determine, information and reproduction of my likeness to any aspect of my volunteer service for the City. I hereby waive my right to first review the use of my likeness before any use or publication.


Truth of Disclosure: I declare under penalty of perjury that all statements and answers provided on this application are true and complete to the best of my knowledge. Furthermore, I understand that false, misleading, or incomplete information shall be cause for disqualification.