Apply for Emergency Medical Technician (EMT)

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Emergency Medical Technician (EMT)
ID:E11042024
Department:Client Services
Resume
Resume:
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
NA Application
REFERRAL SOURCE
Walk-in   Employee   Advertisement   Company   Website   School   Other
Yes   No
Yes   No

If yes, please give dates:

Yes   No
TYPE OF EMPLOYMENT DESIRED
  
  
  
  
  
  
  
  
  
  
  
  
  
ACCOMMODATION QUESTIONS
Yes   No
Yes   No

(If reasonable accommodation is required, please attach a separate piece of paper explaining how you would perform the tasks and what accommodation is needed.)

AUTHORIZATION QUESTIONS
Yes   No
Yes   No
Yes   No
FORMAL EDUCATION
  
  
  
  

School 1

*
Yes   No
*
*
*
Degree   Diploma   GED   Certificate   Other

School 2

Yes   No
Degree   Diploma   GED   Certificate   Other

School 3

Yes   No
Degree   Diploma   GED   Certificate   Other
EMPLOYMENT HISTORY
Yes   No
Yes   No
Yes   No

(A "œNo" will not affect our review of your qualifications. If you answer "œNo" and we need to contact your present employer before we can offer you employment position, we will contact you first.)

NOTE:

Account for all periods of employment or unemployment in the past 10 years; paid or voluntary. Including periods of self-employment, military, and or sabbatical.

Employer 1

*
*
*
*
*

Employer 2

*
*
*
*
*

Employer 3

Employer 4

Employer 5
QUALIFICATIONS

List all certificates, licenses, and or memberships.

Driver's License

*
*

License 1

License 2

License 3

License 4
SKILLS

List number of years certified at each level.

  
  
LANGUAGES
Yes   No
  
  
  
  
  
  
REFERENCES

Please provide three references (not relatives).

Reference 1

*
*
*

Reference 2

Reference 3
PLACE OF RESIDENCE

List where you have lived for at past 10 years (Include month and year only).

Residence 1

Residence 2

Residence 3

Residence 4

Residence 5

Residence 6

Residence 7

Residence 8

Residence 9

Residence 10
ACCOMPLISHMENTS
APPLICANT STATEMENT OF AUTHORIZATIONS AND ACKNOWLEDGEMENTS TO TERMS OF EMPLOYMENT

My signature below indicates that I swear or affirm that the information contained on this application is true and correct to the best of my knowledge, and that I have read, understood, agreed, authorized, certified, and consented to the above statements. This authorization or photocopy shall serve as consent for National Ambulance to request any information concerning my application. I acknowledge that I have had the opportunity to ask questions about these terms and have them answered.

Equal Opportunity Employment
National Ambulance, LLC is an equal opportunity employer and selects the best individual for the job based upon job related qualifications regardless of race, color, creed, genetic makeup, religious preference, sex, sexual orientation, age, national origin, ancestry, pregnancy, marital status, criminal record, mental or physical handicap/disability, veteran status, or any other basis protected by law in any aspect of the provision of ambulance service or in employment practices. National Ambulance will make a reasonable accommodation to known physical or mental limitations or a qualified applicant or employee with a disability, unless the accommodation will impose an undue hardship on the operation of our business. National Ambulance does not tolerate sexual harassment or any other form of harassment in any shape or form.

POLYGRAPH STATEMENT
National Ambulance does not make use of polygraph testing. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment; an employer who violates this law shall be subject to criminal penalties and civil liability.

CONFIDENTIALITY STATEMENT
Your application for employment will be considered by National Ambulance. All records containing personal data are kept protected as required by privacy and confidentiality laws. This information will only be viewed by personnel making hiring recommendations and decisions and bookkeeping personnel. During this time period, your employment history and skills will be reviewed and evaluated by our staff.

NOTIFICATION
If your skills and employment history are the most closely matched to the position requirements, we will contact you by phone or mail within two (2) months to set up an interview. If we do not contact you within two weeks, it means your skills and employment history are not the strongest/closest match to the position or there are more qualified applicants that have been selected to interview for the position. Your application will stay on file for six months and we may consider you for other positions. We encourage you to reapply, after six months or apply for other positions for which you are qualified, by completing a new application. You application is only considered active for six moths from the date of application.

GENERAL EMPLOYMENT REQUIREMENTS
Applicable to Emergency Medical Technician (EMT) or Paramedic (P) or Administrative Assistant-Dispatcher (D) or
Billing Clerk (BC) or Handicap Van Operator (HVO) or (ALL) Applicants
1. (EMT, P) An appropriate level or higher, valid EMT certificate issued by the Commonwealth of Massachusetts.
2. (EMT, P) Valid BLS/Healthcare Provider CPR/AED Card.
3. (EMT, P) Able to lift 150 pounds without additional assistance and 300 pounds with assistance.
4. (ALL) Class D or higher driver's license issued by the Commonwealth of Massachusetts.
5. (ALL) Demonstrate the ability to read, speak, write and understand the English Language.
6. (ALL) Demonstrate the ability to write a short report.
7. (ALL) Pass our interview process to include pre-employment screening.
8. (ALL) Pass New Hire Training.
Sex:
Female
Male
Ethnic Category:
White; not Hispanic origin.
All persons having origins in any of the original peoples of Europe, North Africa, Middle East, or the Indian Subcontinent.
Black; not Hispanic origin.
All persons having origins in any of the black racial groups
Hispanic;
All persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.
Asian or Pacific Islanders;
All persons having origins in any of the original peoples of the Far East, South Asia, or the Pacific Islands. The areas include for example China, Japan, Korea, Philippine Islands and Samoa.
American Indian or Alaskan Native;
All persons having origins in any of the peoples of North America
Are you 40 years of age or older? (Please check all that apply)
Yes
No

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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