825 West Irving Boulevard Irving, TX 75060
Telephone Number 972-721-2696   *   Fax Number 972-721-2582
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* Test Type:  
The first step in the pursuit of becoming a Firefighter or a Police Officer is registering to take the entrance exam. Please complete this registration form. Information about the dates and location will be mailed to registrants prior to the test date.
* Last Name:

* First Name:

Middle Name:
* E-mail Address:
* Address: (Street Address, Apt. No.)
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* Phone:
Alternate Phone:  
Social Security No.* :
Drivers License No:     State:
Year Exp:

NOTE: The information below is being collected for the record keeping and compliance with federal EEO regulations. This information is not part of the application and will not be used as a basis for making employment decisions. Completion of this section is voluntary and does not affect the application process.
Birth Date (MM/DD/YYYY): Gender:
Ethnic Group:
Please see Explanation of Ethnic Groups below:

How did you find out this position? Please specify source:

 Explanation of Ethnic Groups:
 American Indian   (Including Alaskan Natives)
 Asian   (Including Pacific Islander)
 Black   (Not Hispanic)
 Hispanic   (Including persons of Mexican, Puerto Rican, Cuban, Central  or South American, or other Spanish origin/culture regardless of race)
 White   (Not Hispanic)

Privacy Act of 1974 Disclosure AUTHORITY: Management Operations, City of Irving. ROUTINE USES: The SSN is used to identify and track the applications. PURPOSE: tracking of Employment Applications. DISCLOSURE: Voluntary.