High School EMT Sign-on Incentive

Sign-on Incentive Interest Form
If you took or are taking an EMT class in high school and are graduating in 2022, you could earn a $1,000 bonus after joining Acadian Ambulance!

You must be NREMT certified, at least 18 years old and have one year of driving experience.

Please fill out our form below to be connected to a recruiter.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*

Area CodePhone Number
Email Address*
example@example.com
School Name*
Current Grade*

FreshmanSophomoreJuniorSenior
EMT Teacher's Name*
Region(s) of Interest (Select the nearest city to your preferred location.)*

No specific preferenceAlexandria, LouisianaBaton Rouge, LouisianaHammond, LouisianaHouma, LouisianaLafayette, LouisianaLake Charles, LouisianaMonroe, LouisianaNew Orleans, LouisianaJackson County, MississippiMemphis, TennesseeAustin, TexasBeaumont, TexasDallas, TexasHouston, TexasSan Antonio, Texas
Should be Empty:

Sign-on Incentive Interest Form