Our agency, people, capabilities, and service.
Complete the application below. All fields marked with * are required.
Select the role you are applying for and your availability.
All fields are required unless noted.
Provide details on your professional EMS / medical licenses.
Enter card numbers and expiration dates. NIMS and HazMat just need a Completed checkbox.
List relevant EMS/medical employment — most recent first.
Minimum of 3 references required.
Personal, professional, educational, financial — anything. List five things you're working toward.
I certify that all information provided in this application is true and complete to the best of my knowledge. I understand that falsification or omission of information may result in disqualification from consideration or termination of employment. I authorize Millstadt Ambulance Service to verify any of the information provided and to contact references and former employers.
Applicant signature
Sign below to certify everything above. Your signature is recorded on the application PDF that is sent to Millstadt EMS along with the date and time of signing.
A signature is required to submit.
Security check
Select the box below to confirm you are a person.
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