(Proof of citizenship or immigration status will be required upon employment)

If operation of a vehicle is part of the position you are applying for, complete the following:

Note: Depending upon the position you are applying for, moving traffic violations may or may not be an automatic bar to employment. All circumstances will be considered.

List present position/most recent place of employment first (include full-time, part-time, and volunteer.) List every promotion as a new job.

I have read and understand the following:I certify that the answers given in this application are true and complete to the best of my knowledge and I understand that false or misleading statements or omissions on this application may be considered sufficient cause for cancellation of my application or for dismissal if hired, whenever they may be discovered.

I authorize my former and/or current employer (s) and other persons who may have information regarding my qualifications to give Lapeer County EMS representative (s) any and all information concerning my previous or current employment, and any pertinent information that they may have, personal or otherwise, and I release all parties from all liability for any damages, causes of action, including, but not limited to, slander and libel, that may result from furnishing any such information to Lapeer County EMS representative (s). Pursuant to the Bullard-Plawecki Employee Right-to-Know Act, I waive written notice from my current employer and from any of my former employers regarding the disclosure of disciplinary reports,, letters of reprimand, or other notices of disciplinary action contained in my personnel file (even if more than four years old).

I understand that this employment application does not represent an offer or promise of employment and the use of this application form does not indicate that there are any positions open, and does not, in any way, obligate Lapeer County EMS.

I understand that if hired, any employment is at will. This means that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of Lapeer County EMS. I understand that no manager or representative of the Employer has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.

I understand and agree that l am required to abide by all the rules and regulations of Lapeer County EMS.

I understand that any applicant for employment or employee needing accommodation to perform the essential functions of his or her job because of a handicap or disability must notify Lapeer County EMS in writing of the need for accommodation within 182 days after the date the disabled or handicapped individual knew or reasonably should have known that an accommodation was needed.

By typing your name here, this acts as your signature in an electronic version