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Employment Opportunities
Application Form
Applications are reviewed typically the first Monday of every month. Interviews will be scheduled at that time.
*
Indicates required field
What position would you like to apply for?
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Select your preferred opening
Wheelchair Technician
Emergency Medical Technician
Paramedic
Dispatch
Name
*
First
Last
Phone Number
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Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Do you have a valid driver’s license?
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Yes
No
Are you 21 years or older?
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Yes
No
What are your wage expectations?
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Per
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Hour
Week
Month
Year
When are you available to start? (MM/DD/YYYY)
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Has your EMT/Paramedic certification or standing order ever been suspended or revoked?
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Yes
No
What is your Oregon State EMT License Number & Expiration Date or Student Status?
*
What is your National Registry EMT/Paramedic License Number & Expiration Date?
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Please input your educational experience
Please include School/Institution Name, Location, Focus of Study, Dates Attended, and any additional pertinent information.
Additional educational information may be included in an uploaded resume.
First educational level
*
Second Educational Level
*
Third Educational Level
*
Please input your most recent job history
Additional job history may be included with an uploaded resume.
Job Title
*
Company Name
*
Supervisor Name
*
Phone Number
*
Starting Date
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Ending Date
*
Wage/Salary
*
May We Contact
*
Yes
No
Brief Summary of Duties
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Reason For Leaving
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Please include at least 3 professional references
Additional professional and personal references may be included with an uploaded resume.
First Reference Name
*
Job Title
*
Company Name
*
Phone Number
*
Email
*
Second Reference Name
*
Job Title
*
Company Name
*
Phone Number
*
Email
*
Third Reference Name
*
Job Title
*
Company Name
*
Phone Number
*
Email
*
Cover letter and resume uploading
Cover Letter
*
Max file size: 20MB
Resume
*
Max file size: 20MB
APPLICANT CERTIFICATION & AGREEMENT:
(Read carefully before signing) I certify that this information contains no willful misrepresentation or falsification and that the information given by me is true and complete to the best of my knowledge and belief. I understand that if employed, misleading or falsified statements on this application may be considered cause for dismissal.
Enter your first and last name in the text box below to sign your application and agree to these terms.
Name
*
First
Last
Submit
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