Fire Fighter/Emergency Medical Technician
Portales, NM
Full Time
Entry Level
THE CITY OF PORTALES, NEW MEXICO
POSITION POSTING #2021-027
POSITION: FIRE FIGHTER / EMERGENCY MEDICAL TECHNICIAN
DEPARTMENT: FIRE/AMBULANCE
STATUS: NON-EXEMPT
REPORTS TO: SHIFT BATTALION CHIEF
SHIFT: REGULAR – 48 On – 96 Off, Subject to Call
SALARY: $14.29- $20.42 hourly (hourly rate is dependent on experience
& training)
**This position is a safety-sensitive position, subject to random drug/alcohol testing.
GENERAL DESCRIPTION:
Reporting to the Shift Battalion Chief and working with a team, this position shall actively perform fire prevention, public relations, firefighting, emergency medical activities, rescue and special service, apparatus operation, on-going training, record keeping, station, grounds, and apparatus maintenance and repair activities as may be required in a diligent manner, under the supervision of an officer. Work involves an element of personal danger requiring the ability to exercise independent judgment in meeting numerous and varied emergency situations.
TASKS AND RESPONSIBILITIES:
1. Enter hazardous environments to perform rescue and/or suppression activities.
2. Deliver emergency medical care at the scene of various accidents and medical emergencies, transferring victims
to hospital as necessary.
3. Drive emergency vehicles (trucks and ambulances) to sites and operate the water pumps, fire hoses, rescue
equipment, and medical equipment, depending on the emergency situation.
4. Conduct fire inspections and public education programs.
5. Perform various repair and maintenance functions to vehicles, equipment, and facilities.
6. Prepare reports as may be required.
7. Maintain a high level of personal proficiency.
KNOWLEDGE, EXPERIENCE, AND SKILLS:
1. High school diploma or equivalent required.
2. Current New Mexico driver’s license required.
3. Must be at least 21 years of age.
4. Current New Mexico EMT-Basic licensure or eligible to obtain, having completed the EMT-Basic Course,
preferred but not required. Preference dependent on training, experience and level of EMT licensure.
COMMENTS ON PHYSICAL REQUIREMENTS: This position often requires the use of 100% of a person’s strength and stamina for unknown time spans. Sometimes must start from sleep to full speed. Must/Should be in better than average condition and must stay sharp mentally to perform tasks. Required to wear personal protection equipment in all types of weather (-10 to 110 degrees F). Lift and carry, push or pull water filled hoses over all kinds of obstacles and terrain, and move all sizes of patients/victims from all sorts of positions and places.
WORK SCHEDULE:
The regular work week is 48 hours on duty and 96 hours off - seven days per week, subject to call. Additional time may
be required to work after regular hours, on weekends, and holidays, depending on magnitude of emergency situations.
TRAVEL REQUIREMENTS:
1. Travel for meetings and training may be required.
2. Overnight travel may be required.
PRE-EMPLOYMENT REQUIREMENTS:
1. Must pass a background investigation including work history, criminal records, driving records and other records
deemed necessary.
2. Must pass a post-offer pre-employment drug screen administered by a City-designated facility.
3. Must pass a post-offer physical administered by a City-designated facility.
CONDITIONS OF CONTINUED EMPLOYMENT:
1. Candidates must have and maintain a satisfactory driving record and insurability in accordance with the City’s
insurance carrier.
2. Employees must maintain a source of communications for off duty work related communications.
3. Random drug and alcohol testing is a condition of employment and will be tested under the authority of the
NMPRC / FMCSA.
4. Must obtain a valid National Registry EMT-Basic/New Mexico State EMT-Basic License within one year of
employment.
5. Must obtain a valid National Registry AEMT/New Mexico State EMT-Intermediate License within their second year of employment if the employee started as a Firefighter without an EMT-Basic license. A valid National Registry AEMT/New Mexico EMT-Intermediate License within one year of employment if the employee started with an EMT-Basic License.
6. A valid certification at the Firefighter I, and Firefighter II, Driver Operator Level or equivalent shall be obtained at the earliest possible time.
DEADLINE TO SUBMIT REQUIRED APPLICATION: Position to remain open until filled. Review is bi-weekly.
Physical agility testing and oral interview date and time is TBD. Eligible applicants will be contacted and notified of test date. PLEASE RETURN COMPLETED QUESTIONNAIRE AS WELL AS COMPLETED AND NOTARIZED GENERAL WAIVER OF LIABILITY WITH APPLICATION. An Eligibility List will be created for open and anticipated full-time Firefighter/EMT to remain in effect for twelve months. The Portales Fire Department reserves the right to terminate the list at any time.
The City is an Equal Opportunity Employer and Drug Free Workplace.
TO: Portales Fire Department Job Applicants
FROM: Timothy J. Cathey, Fire/EMS Chief
RE: EMT Hiring Process
DATE: July 8, 2021
To all potential job applicants;
Applications for the position of EMT-Firefighter for the Portales Fire Department will remain open until filled.
Review dates bi-weekly thereafter. This letter is to serve as official notification to those applicants that have
applied that the Physical Agility Testing will be held at the Portales Fire Department. Test date TBD. Applicants
will be notified of the test date and time. Those applicants intending to test will need to come get required
paperwork at the Portales Fire Department or print and complete from the City website prior to this date. The
necessary paperwork should be completed and ready to present the morning of the determined date prior to the
physical agility testing. Applicants should report to the department by 7:45 am on scheduled date in preparation
for the testing. This paperwork involves checking the applicant’s blood pressure, and getting a Notary to sign and
notarize a liability waiver. The oral interview process will be the same day immediately following the physical
agility testing. The interviews are scheduled for 30 minutes each and will be assigned through a draw for position
system. Following the completion of the interview process, formal notification of the candidate selection and
eligibility list will be completed no later than the following Friday.
THE CITY OF PORTALES,
NEW MEXICO
JOB DESCRIPTION / QUESTIONNAIRE
TITLE: FIRE FIGHTER / EMERGENCY MEDICAL TECHNICIAN
DEPARTMENT: FIRE/AMBULANCE DATE: 1/01/2021
NON-EXEMPT
REPORTS TO: SHIFT BATTALION CHIEF
SHIFT: REGULAR – 48 ON – 96 OFF SUBJECT TO CALL
**This position is a safety-sensitive position, subject to random drug/alcohol testing.
GENERAL DESCRIPTION:
Reporting to the Shift Battalion Chief and working with a team, this position shall actively perform fire
prevention, public relations, firefighting, emergency medical activities, rescue and special service,
apparatus operation, on-going training, record keeping, station, grounds, and apparatus maintenance
and repair activities as may be required in a diligent manner, under the supervision of an officer. Work
involves an element of personal danger requiring the ability to exercise independent judgment in
meeting numerous and varied emergency situations.
TASKS AND RESPONSIBILITIES:
Although the following are typical of the tasks and or responsibilities routinely performed, additional
tasks and/or responsibilities requiring comparable or lesser skills, knowledge, or dexterity may be assigned.
1. Enter hazardous environments to perform rescue and/or suppression activities.
2. Deliver emergency medical care at the scene of various accidents and medical emergencies,
transferring victims to hospital as necessary.
3. Drive emergency vehicles (trucks and ambulances) to sites and operate the water pumps, fire
hoses, rescue equipment, and medical equipment, depending on the emergency situation.
4. Conduct fire inspections and public education programs.
5. Perform various repair and maintenance functions to vehicles, equipment, and facilities.
6. Prepare reports as may be required.
7. Maintain a high level of personal proficiency.
Can you perform the above tasks?_____________________________________________________
If not, is there a reasonable accommodation that would allow you to perform these tasks?_________________________________________________________________________________
MACHINES, TOOLS, EQUIPMENT AND WORK AIDS USED:
1. Fire & EMS apparatus.
2. Generators, forcible entry tools (rescue tools, air chisel, air bags, etc.), light towers, hoses &
nozzles, pumps, chain saw, hydraulic and regular extension ladders, ventilation fans.
3. Shovels, axes, saws, pike poles, mops, brooms, vacuums, buffers.
4. Welding, painting, and various shop tools.
5. Defibrillators, monitors, intravenous administration equipment, spinal immobilization devices,
cots, bandages, splints, O2 delivery devices.
6. Personal computer and various office equipment.
Can you operate/use the above items?________________________________________________
If not, is there a reasonable accommodation that would allow you to use these items?______________________________________________________________________________
MATERIALS AND/OR PRODUCTS HANDLED:
1. Human beings, blood products, vomitus, body excretions.
2. Water, synthetics, and various chemicals as required by the job (i.e. Haz-mat).
3. Medications and first aid materials.
4. Janitorial chemicals and cleaning substances.
5. Petroleum based products such as gas, diesel, oil, and grease.
6. Other gases such as oxygen, acetylene.
Can you handle the above products?__________________________________
If not, is there a reasonable accommodation that would allow you to handle these products?_________________________________________________________________
KNOWLEDGE, EXPERIENCE, AND SKILLS:
1. High school diploma or equivalent required.
2. Current New Mexico driver’s license required.
3. Must be at least 21 years of age.
4. Current New Mexico EMT-Basic licensure or eligible to obtain one, having completed the EMT-
Basic Course. (Preferred, but not required.) Preference dependent on training, experience and
level of EMT licensure.
Do you meet the above requirements?________________________________
If not, can you meet these requirements in the near future or with training?___________________________
How and when?__________________________________________________
You are not required to disclose information about physical or mental limitations that you believe will
not interfere with your capability to perform the requirements of the position. However, if you want the
employer to consider special arrangements to accommodate a physical or mental impairment, you may
identify that impairment in the space provided and suggest the kind of accommodation that you believe
would be appropriate.
COMMENTS ON PHYSICAL REQUIREMENTS: This position often requires the use of 100% of a
person’s strength and stamina for unknown time spans. Sometimes must start from sleep to full speed.
Must/Should be in better than average condition and must stay sharp mentally to perform tasks.
Required to wear personal protection equipment in all types weather (-10 to 110 degrees F). Lift and
carry, push or pull water filed hoses over all kinds of obstacles and terrain, and move all sizes of
patients/victims from all sorts of positions and places.
Can you execute the above physical requirements?____________________________________________
If not, is there a reasonable accommodation that would allow you to perform these requirements?_________________________________________________________________________________
WORK SCHEDULE:
The regular work week is 48 hours on duty and 96 hours off - seven days per week, subject to call.
Additional time may be required to work after regular hours, on weekends, and holidays, depending on
magnitude of emergency situations.
Please note any exceptions you may have to the above schedule
TRAVEL REQUIREMENTS:
3. Travel for meetings and training may be required.
4. Overnight travel may be required.
PRE-EMPLOYMENT REQUIREMENTS:
4. Must pass a background investigation including work history, criminal records, driving records
and other records deemed necessary.
5. Must pass a post-offer pre-employment drug screen administered by a City-designated facility.
6. Must pass a post-offer physical administered by a City-designated facility.
CONDITIONS OF CONTINUED EMPLOYMENT:
7. Candidates must have and maintain a satisfactory driving record and insurability in accordance with the City’s insurance carrier.
8. Employees must maintain a source of communications for off duty work related communications.
9. Random drug and alcohol testing is a condition of employment and will be tested under the authority of the NMPRC / FMCSA.
10. Must obtain a valid National Registry EMT-Basic/New Mexico State EMT-Basic License within one year of employment.
11. Must obtain a valid National Registry AEMT/New Mexico State EMT-Intermediate License within their second year of employment if the employee started as a Firefighter without an EMT-Basic license. A valid National Registry AEMT/New Mexico EMT-Intermediate License within one year of employment if the employee started with an EMT-Basic License.
12. A valid certification at the Firefighter I, and Firefighter II, Driver Operator Level or equivalent shall
be obtained at the earliest possible time.
CERTIFICATION & AGREEMENT
I hereby certify that the facts set forth in the above Job Description/Questionnaire are true and complete
to the best of my knowledge. I understand that falsified statements of this form shall be considered
sufficient cause for dismissal. The City of Portales is hereby authorized to make any investigation
deemed necessary to verify the information, and any law enforcement or other organization is
authorized to give all information relative to my employment, and the City of Portales from any liability
for any claim or damage which may result.
_________________________________________________________
Signature Date
USE THE REMAINING SPACE AND/OR ATTACHMENT TO LIST ANY SPECIAL SKILLS YOU MAY
HAVE RELATIVE TO THIS JOB, OR TO MAKE ANY FURTHER COMMENTS.
hereby release the City of Portales and Portales Fire Department of any and all liability and
compensation should injury or illness occur from my performing the physical agility testing for
consideration of employment with the Portales Fire Department.
__________________________________ ___________________________
Signature of Applicant Date
The foregoing instrument was acknowledged before me this __________________ day of
_________________________, 20__________ .
(SEAL) Notary Public
My commission expires: _______________________________
POSITION POSTING #2021-027
POSITION: FIRE FIGHTER / EMERGENCY MEDICAL TECHNICIAN
DEPARTMENT: FIRE/AMBULANCE
STATUS: NON-EXEMPT
REPORTS TO: SHIFT BATTALION CHIEF
SHIFT: REGULAR – 48 On – 96 Off, Subject to Call
SALARY: $14.29- $20.42 hourly (hourly rate is dependent on experience
& training)
**This position is a safety-sensitive position, subject to random drug/alcohol testing.
GENERAL DESCRIPTION:
Reporting to the Shift Battalion Chief and working with a team, this position shall actively perform fire prevention, public relations, firefighting, emergency medical activities, rescue and special service, apparatus operation, on-going training, record keeping, station, grounds, and apparatus maintenance and repair activities as may be required in a diligent manner, under the supervision of an officer. Work involves an element of personal danger requiring the ability to exercise independent judgment in meeting numerous and varied emergency situations.
TASKS AND RESPONSIBILITIES:
1. Enter hazardous environments to perform rescue and/or suppression activities.
2. Deliver emergency medical care at the scene of various accidents and medical emergencies, transferring victims
to hospital as necessary.
3. Drive emergency vehicles (trucks and ambulances) to sites and operate the water pumps, fire hoses, rescue
equipment, and medical equipment, depending on the emergency situation.
4. Conduct fire inspections and public education programs.
5. Perform various repair and maintenance functions to vehicles, equipment, and facilities.
6. Prepare reports as may be required.
7. Maintain a high level of personal proficiency.
KNOWLEDGE, EXPERIENCE, AND SKILLS:
1. High school diploma or equivalent required.
2. Current New Mexico driver’s license required.
3. Must be at least 21 years of age.
4. Current New Mexico EMT-Basic licensure or eligible to obtain, having completed the EMT-Basic Course,
preferred but not required. Preference dependent on training, experience and level of EMT licensure.
COMMENTS ON PHYSICAL REQUIREMENTS: This position often requires the use of 100% of a person’s strength and stamina for unknown time spans. Sometimes must start from sleep to full speed. Must/Should be in better than average condition and must stay sharp mentally to perform tasks. Required to wear personal protection equipment in all types of weather (-10 to 110 degrees F). Lift and carry, push or pull water filled hoses over all kinds of obstacles and terrain, and move all sizes of patients/victims from all sorts of positions and places.
WORK SCHEDULE:
The regular work week is 48 hours on duty and 96 hours off - seven days per week, subject to call. Additional time may
be required to work after regular hours, on weekends, and holidays, depending on magnitude of emergency situations.
TRAVEL REQUIREMENTS:
1. Travel for meetings and training may be required.
2. Overnight travel may be required.
PRE-EMPLOYMENT REQUIREMENTS:
1. Must pass a background investigation including work history, criminal records, driving records and other records
deemed necessary.
2. Must pass a post-offer pre-employment drug screen administered by a City-designated facility.
3. Must pass a post-offer physical administered by a City-designated facility.
CONDITIONS OF CONTINUED EMPLOYMENT:
1. Candidates must have and maintain a satisfactory driving record and insurability in accordance with the City’s
insurance carrier.
2. Employees must maintain a source of communications for off duty work related communications.
3. Random drug and alcohol testing is a condition of employment and will be tested under the authority of the
NMPRC / FMCSA.
4. Must obtain a valid National Registry EMT-Basic/New Mexico State EMT-Basic License within one year of
employment.
5. Must obtain a valid National Registry AEMT/New Mexico State EMT-Intermediate License within their second year of employment if the employee started as a Firefighter without an EMT-Basic license. A valid National Registry AEMT/New Mexico EMT-Intermediate License within one year of employment if the employee started with an EMT-Basic License.
6. A valid certification at the Firefighter I, and Firefighter II, Driver Operator Level or equivalent shall be obtained at the earliest possible time.
DEADLINE TO SUBMIT REQUIRED APPLICATION: Position to remain open until filled. Review is bi-weekly.
Physical agility testing and oral interview date and time is TBD. Eligible applicants will be contacted and notified of test date. PLEASE RETURN COMPLETED QUESTIONNAIRE AS WELL AS COMPLETED AND NOTARIZED GENERAL WAIVER OF LIABILITY WITH APPLICATION. An Eligibility List will be created for open and anticipated full-time Firefighter/EMT to remain in effect for twelve months. The Portales Fire Department reserves the right to terminate the list at any time.
The City is an Equal Opportunity Employer and Drug Free Workplace.
TO: Portales Fire Department Job Applicants
FROM: Timothy J. Cathey, Fire/EMS Chief
RE: EMT Hiring Process
DATE: July 8, 2021
To all potential job applicants;
Applications for the position of EMT-Firefighter for the Portales Fire Department will remain open until filled.
Review dates bi-weekly thereafter. This letter is to serve as official notification to those applicants that have
applied that the Physical Agility Testing will be held at the Portales Fire Department. Test date TBD. Applicants
will be notified of the test date and time. Those applicants intending to test will need to come get required
paperwork at the Portales Fire Department or print and complete from the City website prior to this date. The
necessary paperwork should be completed and ready to present the morning of the determined date prior to the
physical agility testing. Applicants should report to the department by 7:45 am on scheduled date in preparation
for the testing. This paperwork involves checking the applicant’s blood pressure, and getting a Notary to sign and
notarize a liability waiver. The oral interview process will be the same day immediately following the physical
agility testing. The interviews are scheduled for 30 minutes each and will be assigned through a draw for position
system. Following the completion of the interview process, formal notification of the candidate selection and
eligibility list will be completed no later than the following Friday.
THE CITY OF PORTALES,
NEW MEXICO
JOB DESCRIPTION / QUESTIONNAIRE
TITLE: FIRE FIGHTER / EMERGENCY MEDICAL TECHNICIAN
DEPARTMENT: FIRE/AMBULANCE DATE: 1/01/2021
NON-EXEMPT
REPORTS TO: SHIFT BATTALION CHIEF
SHIFT: REGULAR – 48 ON – 96 OFF SUBJECT TO CALL
**This position is a safety-sensitive position, subject to random drug/alcohol testing.
GENERAL DESCRIPTION:
Reporting to the Shift Battalion Chief and working with a team, this position shall actively perform fire
prevention, public relations, firefighting, emergency medical activities, rescue and special service,
apparatus operation, on-going training, record keeping, station, grounds, and apparatus maintenance
and repair activities as may be required in a diligent manner, under the supervision of an officer. Work
involves an element of personal danger requiring the ability to exercise independent judgment in
meeting numerous and varied emergency situations.
TASKS AND RESPONSIBILITIES:
Although the following are typical of the tasks and or responsibilities routinely performed, additional
tasks and/or responsibilities requiring comparable or lesser skills, knowledge, or dexterity may be assigned.
1. Enter hazardous environments to perform rescue and/or suppression activities.
2. Deliver emergency medical care at the scene of various accidents and medical emergencies,
transferring victims to hospital as necessary.
3. Drive emergency vehicles (trucks and ambulances) to sites and operate the water pumps, fire
hoses, rescue equipment, and medical equipment, depending on the emergency situation.
4. Conduct fire inspections and public education programs.
5. Perform various repair and maintenance functions to vehicles, equipment, and facilities.
6. Prepare reports as may be required.
7. Maintain a high level of personal proficiency.
Can you perform the above tasks?_____________________________________________________
If not, is there a reasonable accommodation that would allow you to perform these tasks?_________________________________________________________________________________
MACHINES, TOOLS, EQUIPMENT AND WORK AIDS USED:
1. Fire & EMS apparatus.
2. Generators, forcible entry tools (rescue tools, air chisel, air bags, etc.), light towers, hoses &
nozzles, pumps, chain saw, hydraulic and regular extension ladders, ventilation fans.
3. Shovels, axes, saws, pike poles, mops, brooms, vacuums, buffers.
4. Welding, painting, and various shop tools.
5. Defibrillators, monitors, intravenous administration equipment, spinal immobilization devices,
cots, bandages, splints, O2 delivery devices.
6. Personal computer and various office equipment.
Can you operate/use the above items?________________________________________________
If not, is there a reasonable accommodation that would allow you to use these items?______________________________________________________________________________
MATERIALS AND/OR PRODUCTS HANDLED:
1. Human beings, blood products, vomitus, body excretions.
2. Water, synthetics, and various chemicals as required by the job (i.e. Haz-mat).
3. Medications and first aid materials.
4. Janitorial chemicals and cleaning substances.
5. Petroleum based products such as gas, diesel, oil, and grease.
6. Other gases such as oxygen, acetylene.
Can you handle the above products?__________________________________
If not, is there a reasonable accommodation that would allow you to handle these products?_________________________________________________________________
KNOWLEDGE, EXPERIENCE, AND SKILLS:
1. High school diploma or equivalent required.
2. Current New Mexico driver’s license required.
3. Must be at least 21 years of age.
4. Current New Mexico EMT-Basic licensure or eligible to obtain one, having completed the EMT-
Basic Course. (Preferred, but not required.) Preference dependent on training, experience and
level of EMT licensure.
Do you meet the above requirements?________________________________
If not, can you meet these requirements in the near future or with training?___________________________
How and when?__________________________________________________
You are not required to disclose information about physical or mental limitations that you believe will
not interfere with your capability to perform the requirements of the position. However, if you want the
employer to consider special arrangements to accommodate a physical or mental impairment, you may
identify that impairment in the space provided and suggest the kind of accommodation that you believe
would be appropriate.
COMMENTS ON PHYSICAL REQUIREMENTS: This position often requires the use of 100% of a
person’s strength and stamina for unknown time spans. Sometimes must start from sleep to full speed.
Must/Should be in better than average condition and must stay sharp mentally to perform tasks.
Required to wear personal protection equipment in all types weather (-10 to 110 degrees F). Lift and
carry, push or pull water filed hoses over all kinds of obstacles and terrain, and move all sizes of
patients/victims from all sorts of positions and places.
Can you execute the above physical requirements?____________________________________________
If not, is there a reasonable accommodation that would allow you to perform these requirements?_________________________________________________________________________________
WORK SCHEDULE:
The regular work week is 48 hours on duty and 96 hours off - seven days per week, subject to call.
Additional time may be required to work after regular hours, on weekends, and holidays, depending on
magnitude of emergency situations.
Please note any exceptions you may have to the above schedule
TRAVEL REQUIREMENTS:
3. Travel for meetings and training may be required.
4. Overnight travel may be required.
PRE-EMPLOYMENT REQUIREMENTS:
4. Must pass a background investigation including work history, criminal records, driving records
and other records deemed necessary.
5. Must pass a post-offer pre-employment drug screen administered by a City-designated facility.
6. Must pass a post-offer physical administered by a City-designated facility.
CONDITIONS OF CONTINUED EMPLOYMENT:
7. Candidates must have and maintain a satisfactory driving record and insurability in accordance with the City’s insurance carrier.
8. Employees must maintain a source of communications for off duty work related communications.
9. Random drug and alcohol testing is a condition of employment and will be tested under the authority of the NMPRC / FMCSA.
10. Must obtain a valid National Registry EMT-Basic/New Mexico State EMT-Basic License within one year of employment.
11. Must obtain a valid National Registry AEMT/New Mexico State EMT-Intermediate License within their second year of employment if the employee started as a Firefighter without an EMT-Basic license. A valid National Registry AEMT/New Mexico EMT-Intermediate License within one year of employment if the employee started with an EMT-Basic License.
12. A valid certification at the Firefighter I, and Firefighter II, Driver Operator Level or equivalent shall
be obtained at the earliest possible time.
CERTIFICATION & AGREEMENT
I hereby certify that the facts set forth in the above Job Description/Questionnaire are true and complete
to the best of my knowledge. I understand that falsified statements of this form shall be considered
sufficient cause for dismissal. The City of Portales is hereby authorized to make any investigation
deemed necessary to verify the information, and any law enforcement or other organization is
authorized to give all information relative to my employment, and the City of Portales from any liability
for any claim or damage which may result.
_________________________________________________________
Signature Date
USE THE REMAINING SPACE AND/OR ATTACHMENT TO LIST ANY SPECIAL SKILLS YOU MAY
HAVE RELATIVE TO THIS JOB, OR TO MAKE ANY FURTHER COMMENTS.
PORTALES FIRE DEPARTMENT
GENERAL WAIVER OF LIABILITY
MUST BE FILLED OUT AND BROUGHT TO PHYSICAL AGILITY TEST
Let it be known by my affixed signature that I _____________________________________MUST BE FILLED OUT AND BROUGHT TO PHYSICAL AGILITY TEST
hereby release the City of Portales and Portales Fire Department of any and all liability and
compensation should injury or illness occur from my performing the physical agility testing for
consideration of employment with the Portales Fire Department.
__________________________________ ___________________________
Signature of Applicant Date
The foregoing instrument was acknowledged before me this __________________ day of
_________________________, 20__________ .
(SEAL) Notary Public
My commission expires: _______________________________
Apply for this position
Required*