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2. Citizens' Fire Academy Application
   Skokie Fire Department
3. 
5. Last Name:
7. First Name:
8. Middle Initial:
10. Address:
11. Apt #.
13. City:
14. State:
15. Zip Code:
17. Home Phone:
18. Work Phone:
20. Are you currently a member of the fire department?

    1. Yes

    1. No
22. If yes, where?
24. If the academy is filled, would you like to be placed on the waiting list?

    1. Yes

    1. No
26. I am at least 18 years of age, and either a resident or an employee of the Village of Skokie. I verify all information on the Citizens’ Fire Academy Application to be accurate and truthful. I further understand the Skokie Fire Department will be conducting a background check that may include, but not limited to, any criminal history. The Skokie Fire Department reserves the right to accept or reject any applicant for the Citizens’ Fire Academy. I understand and agree to the terms stated above.
28. Signature:
29. Date:
31. This application can also be completed by hand using the below link.
    Application

    Please send to the attention of: Captain Thomas Doran, Fire Prevention Bureau, 7424 Niles Center Road Skokie, Illinois 60077. Or Email: Christopher.vrshek@skokie.org

33. Upon submission, please call (847) 982-5340 to provide information for a background check.
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit Submit and Print

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