Colorado Springs Fire Department Firefighter Interest Form 2013 Survey

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Colorado Springs Fire Department

Firefighter Interest Form 2013

Please provide us with your contact information

1. Name:

Name:

2. Street Address:

Street Address:

3. City:

City:

4. State:

State:

5. Zip/Postal Code:

Zip/Postal Code:

6. Email address:

Email address:

7. Phone number

Phone number

The information provided will be kept confidential and this form will be maintained in a separate location from any future applications. This information is voluntary and neither disclosure of the information nor refusal to provide it will adversely affect consideration of future applications.

8. Your gender

Your gender Female

Male

9. Your ethnicity (select all that apply)

Your ethnicity (select all that apply) American Indian or Alaskan Native

Asian

Black/African American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White

10. Indicate how you learned about the Colorado Springs Fire Department

Indicate how you learned about the Colorado Springs Fire Department Job Fair

CSFD employee

City employee

City website

CSFD website

CSFD Facebook site

CSFD Twitter site

Other, please specify

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