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EMT Application

Please complete the EMT application in full, providing accurate personal information, contact details, and any required documentation. Be sure to answer every question, upload all necessary files, and review your entries before submitting. Incomplete applications may delay processing, so take a moment to ensure everything is filled out correctly before you finalize your submission.

Name(Required)
MM slash DD slash YYYY
Education(Required)
I have a valid Driver License *(Required)
I certify I can pass Drug Alcohol Screening Test(Required)
I certify I can pass a criminal background check *(Required)
Have you ever been convicted of a violation of federal or state law pertaining to medical malpractice or drugs of any kind?(Required)
Have you been convicted of a misdemeanor violation, excluding minor traffic violations within the past 15 years?(Required)
Have you ever been convicted of a felony in any court of law? *(Required)
Are you Pregnant - Must Lift and Carry 120lb with a partner *(Required)
Please select the following items available you have for orientation(Required)
Medical/Fire Safety Experience(Required)
Polo Shirt Size(Required)