Application Firefighter Exchange International Fellowship Fire Fighter Only full time TFS employees are eligible to apply 1. Application details:Please Insert ID photograph here:Max. file size: 64 MB.Name: Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Last Rank: Date of Birth: Employee Number:Years of Full Time Service:Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Work Number: (Include international area code): +61Mobile: (Include international area code): +61Work Email: Home Email: I wish to Exchange with: International: Within Australia/ New Zealand: Please specify location: (City, State and Country) Is English your first Language: Yes No Do you speak any other languages? Other Languages Proficiency: Do you hold citizenship in another country: Yes No Country of Citizenship: In order to exchange English will need to be your primary language. TFS may consider exchanges to countries where English is not the primary language if you demonstrate high proficiency in another language. 2. Details of Next of Kin in your Home CountryName Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Last Relationship to you: Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Telephone: (Include international area code): +61Mobile: (Include international area code): +61Work Email: Home Email: 3. Family DetailsPlease provided details of family members who will accompany you on the exchange. Person 1Name: Relationship: Country of Residence Date of Birth: Person 2Name: Relationship: Country of Residence: Date of Birth: Person 3Name: Relationship: Country of Residence: Date of Birth: Person 4Name: Relationship: Country of Residence: Date of Birth: Are you aware of any reason why any of the above would fail to satisfy immigrations requirements in the country of your proposed visit? Yes No If yes, please provide details why: Will any family member for whom you are responsible remain in your home country/ state? Yes No Please detail: 4. Briefly describe your fire station:Turnout area, Personnel, Appliance, etc. (max 500 words) Firefighters should NOT make a commitment to the exchange partner that they will be working at a particular station or with a particular crew. This will be at the discretion of the TFS. 5. Briefly describe duties in your current position or provide a copy of your position description:To upload position description:Max. file size: 64 MB.Firefighter Duties (Please select): Work as a member of a team which responds to emergency incidents. Provide basic life support (first aid and enhanced rescue services). Operate and use emergency response vehicles and equipment in a safe and effective manner. Undertake maintenance and testing duties to ensure the upkeep of fire service equipment and property. Acquire and maintain competencies and pursue opportunities for self-development through participation in learning and development activities. Promote community awareness in fire safety and fire prevention through participation in the inspection of property, buildings, emergency response equipment and community education programs. Assist with the development of pre-incident plans. Provide accurate information in reports and statistical data, including the use of computer systems as required. Select AllOther duties6. TFS work hours and leave entitlementAnnual Leave (days per year): Personal Leave (sick) (Hours per year): Work Hours per week: Total hours Total Hours over an 8 week period Shift Roster Hours (Qty & Schedule) - Night Shift Roster Hours (Qty & Schedule) - Day Shift Roster Hours (Qty) - Days Off 7. Accommodation Unless discussed, exchange partners have sole occupancy of your accommodation. Exchange partners have the option of exchanging jobs and NOT accommodation. Please attach photographs of the interior and exterior of your house.Max. file size: 64 MB.If you are successful in obtaining an exchange, would your usual accommodation be available for your exchange partner for the full term of this fellowship? Yes No Other If you answered Yes - please complete 7A below. If No - please consider how you will assist an exchange partner to locate accommodation.7A. Property DetailsAccommodation type: House Villa Unit Apartment/ Town house Type Other: Ownership Status Own Purchasing (mortgage) Rent Ownership Other: Number of Bedrooms: One Two Three Four Five Room 1Room 1 Length:Room 1 Width:Room 1 Ensuite: Yes No Room 1 Bed Size: Single Queen King Other Room 2Room 2 Length:Room 2 Width:Room 2 Ensuite: Yes No Room 2 Bed Size: Single Queen King Other Room 3Room 3 Length:Room 3 Width:Room 3 Ensuite: Yes No Room 3 Bed Size: Single Queen King Other Room 4Room 4 Length:Room 4 Width:Room 4 Ensuite: Yes No Room 4 Bed Size: Single Queen King Other Room 5Room 5 Length:Room 5 Width:Room 5 Ensuite: Yes No Room 5 Bed Size: Single Queen King Other Other dwelling details that may be relevant: 8. General Domestic InformationWill your house insurance be valid when occupied by the visiting exchange partner? Yes No Other Will your contents insurance also cover the effects belonging to the visiting exchange partner? Yes No Other TransportWhat is your normal method of travel to work? Private Vehicle Bus Bicycle Walk Other Is public transport available Yes No Other Is off street parking available? Yes No Other Distance to your nearest public transport (km)? Distance by public transport to your workplace (km)? Distance from Accommodation to your local shop (km)? Distance from Accommodation to nearest major shop centre(km)? If this application is approved and you then locate an exchange partner you will be required to complete the ‘Information for Exchange Partner’ form. If an exchange proceeds you will be required to complete the ‘Memorandum of Understanding’ form. A copy of each is to be held by each exchange partner and Exchange Coordinator.9. Firefighter Exchange Fellowship – Statement of PurposePlease provide a brief statement of purpose and your likely contributions to the community and the TFS upon your return. (max. half page)10. Applicant Agreement/ Signing PageApplicant Name: Applicant Signature: Date MM slash DD slash YYYY Internal Use Only11. ApprovalsResidence Inspection The residence to be exchanged must be inspected by the TFS before forwarding this application to the Exchange Coordinator to ensure it is appropriate for the exchange.Premises inspected and found satisfactory Yes No Other Date MM slash DD slash YYYY Exchange Coordinator Name: Exchange Coordinator rank: Exchange Coordinator Signature: TFS Exchange Coordinator Endorsement This applicant is recommended as highly suitable for a Firefighter Exchange Fellowship on the grounds of personal character, professionalism and competence.Exchange Coordinator Name Exchange Coordinator Signature: Date MM slash DD slash YYYY Address Street Address City State / Province / Region ZIP / Postal Code Work Number: (Include international area code): +61Work Mobile: (Include international area code): +61Email Website TFS Regional Chief Endorsement This applicant is recommended as highly suitable for a Firefighter Exchange Fellowship on the grounds of personal character, professionalism and competence.Regional Chief: North West North South Regional Chief Name: Regional Chief Signature: Date MM slash DD slash YYYY Chief Officer Endorsement This applicant is recommended as highly suitable for a Firefighter Exchange Fellowship on the grounds of personal character, professionalism and competence.Chief Officer Name: Chief Officer Signature: Date MM slash DD slash YYYY Tasmania Fire Service, GPO Box 1526, Hobart, Tasmania, Australia, www.fire.tas.gov.au Exchange Coordinator e-mail stewart.mckinlay@fire.tas.gov.au CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
