Area Ambulance Service Employment Application

  • Area Ambulance Service Employment Application

  • AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER

  • Applicant Information

    Federal law obligates us to provide reasonable accommodation to the known disabilities of applicants and employees, unless to do so would pose an undo hardship. Please feel free to let us know if you need an accommodation to complete the application process or to perform any essential elements of the position sought.

     Applicants are considered for all positions, and employees are treated during employment, without regard to race, color, religion, sex, national origin, ancestry, marital status, age, disability, veteran status, or any other prohibited basis of discrimination, as provided under applicable state and federal law.

  • General Information

  • Education

    Please list education or specialized experience that relates to the position(s) for which you are applying. Exclude names or terms which indicate, for example, race, color, religion, sex, disability or national origin.
    • Education Section 1 
    • Education Section 2 
    • Education Section 3 
    •  

    • Previous Employment

      Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate, for example, race, color, religion, sex, disability or national origin.
    • Job 1 
    • Job 2 
    • Job 3 
    • Job 4 
    •  

    • Record Identification

    • Below, list all traffic citations received and accidents you have been involved in during the last five years:

    • PERSONAL REFERENCES

    • Person to be contacted in the event of an accident or emergency:

    • Agreement

    • I certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked by the company unless I have indicated to the contrary. I authorize the references listed, as well as all other individuals whom the Company contacts, to provide the Company any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and persons from all liability for any damages that may result from furnishing such information to the Company as well as from the use or disclosure of such information by the Company or any of its agents, employees, or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer of employment or, if I am hired, my dismissal from employment.

      I understand that this application is not a contract of employment.

      In consideration of my employment, I agree to conform to the rules and standards of the Company, as amended by the Company from time to time in its discretion. I further agree that my employment can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of the Company. I understand that no employee or representative of the Company, other than its president, has the authority to make any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. Further, the president of the Company may not alter the "at-will" nature of the employment relationship unless such an alteration is made explicitly in writing and signed by the president.

      I also understand that all offers of employment are conditioned on the provision of satisfactory proof of an applicant's identity and legal authority to work in the United States.

    • Clear
    • Should be Empty: