Fire Mentor Application Form

Best time to call: SelectAMPMAnytime

1. Confidentiality is imperative between the mentor and recruit / probationary.
Barring any safety issue to recruit/probationary/mentor/other crew members – will you be able to maintain confidentiality? SelectYesNo


I have read and signed the Confidentiality Agreement. SelectYesNo


2. Have you read the Mentor Program Guidelines and agree to the time commitment? SelectYesNo


3. Please briefly describe why you would like to be a mentor:

4. Please list specific skills / subject interest / areas of expertise:

5. Have you received any disciplinary action within DFD within the last 5 years? SelectYesNo If yes, please explain:

6. Please select ALL that apply: (used only to try to best pair Mentors)

Are you a Cadet? SelectYesNo

Do you have family on DFD? SelectYesNo

Did you have a Lateral Transfer? SelectYesNo

Do you have Military Experience? SelectYesNo

Did you move from out of state for employment with DFD? SelectYesNo

Did you work for another Fire Dept. before hired with DFD? SelectYesNo

Do you have kids?" SelectYesNo