MBFTE New Firefighter Application

For Firefighters needing to renew their license,
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Oath: I certify that there are no misrepresentations, omissions or falsifications in the foregoing statements, and that the above answers made by me are true, complete, and correct to the best of my knowledge and belief, and are made in good faith. By signing this application, I am agreeing that, when asked, I will sign an Informed Consent form for the purpose of allowing the Minnesota Bureau of Criminal Apprehension to disclose all criminal history record information to the MBFTE. I understand that if I choose not to do so, I cannot become a licensed firefighter in the State of Minnesota.

1.Electronic Signature Agreement. By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide Minnesota Board of Firefighter Training and Education via US Bank or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and Minnesota Board of Firefighter Training and Education. You further agree that each use of your E-Signature in obtaining a US Bank transaction online service constitutes your agreement to be bound by the terms and conditions of the US Bank Disclosures and Agreements as they exist on the date of your E-Signature.

2. Consent to Electronic Delivery. You specifically agree to receive and/or obtain any and all US Bank transaction related "Electronic Communications" (defined below) via Minnesota Board of Firefighter Training and Education and/or US Bank. The term "Electronic Communications" includes, but is not limited to, any and all current and future notices and/or disclosures that various federal and/or state laws or regulations require that we provide to you, as well as such other documents, statements, data, records and any other communications regarding your relationship with Minnesota Board of Firefighter Training and Education. You acknowledge that, for your records, you are able to use US Bank online transaction to retain Electronic Communications by printing and/or downloading and saving this Agreement and any other agreements and Electronic Communications, documents, or records that you agree to using your E-Signature. You accept Electronic Communications provided via Minnesota Board of Firefighter Training and Education and/or US Bank as reasonable and proper notice, for the purpose of any and all laws, rules, and regulations, and agree that such electronic form fully satisfies any requirement that such communications be provided to you in writing or in a form that you may keep.


The data which you furnish on this form will be used by the Minnesota Board of Firefighter Training and Education(MBFTE) to assess your qualifications for licensure. You are not legally required to provide this data; however, if you fail to do so, MBFTE may be unable to process this application. After issuance of a professional license, the information contained in this application will be public information, pursuant to Minnesota Statutes, Chapter 13. Under Minnesota Statutes, Chapter 13, Social Security Numbers are not public information. For more information,
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