Central Berkeley Fire & EMS

Step 1 of 4

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth *

Social Security Number *

Email *

Home Phone *

Work Phone

Cell Phone *

Cell Phone Type *

Do you possess a valid drivers license? *

Driver's License Number *

Driver's License State *

License Classification *

Do you have any moving violations in the last three years? *

Have you been convicted of a felony? *

If yes, please explain the circumstances.

CBF&E Full Time Application