Candidate Questionnaire

Contact information

To begin, please provide your personal contact information.We will use this to continue the conversation after you have submitted this questionnaire.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
I will be able to respond from a Livingston, NJ address when paged on assigned duty nights.*

yesno
Address*

Street Address

Street Address Line 2

CityState

Zip Code

Membership qualifications.

To help you understand the requirements of serving with the Livingston First Aid Squad, please review all of the following requirements. You must be able
Driver Info*

I am 17 + years of ageI have a NJ driver’s license
I am physically able to:*

Lift and carry patientsWork in varied environmental conditions (heat, cold, rain, snow)Use good judgment and remain calm in high-stress situationsMaintain a professional and empathic attitude with patients who may be critically ill or injured.
I am available to:*

Serve assigned weekly evening shift 7 PM to 7 AMRespond to weekend backup calls

Current Training/Experience

We are currently seeking candidates to provide patient care.LFAS offers potential members the opportunity to pursue necessary EMS training.
Current EMS Training Level*

I want to join and need trainingI have current EMT certificationI have current EMR certification
Previous Experience

2 or more years riding with another squad or paid serviceOther first responder experience (EMS, fire fighter, law enforcement)CPR certifiedOther medical fieldOther

Thank you for bringing your skill and experience! As a qualified EMT or EMR you can apply as a probationary member. Click SUBMIT to record your information.You will be contacted to continue the conversation.

Contact information