• APPLICATION FOR EMPLOYMENT

  • Erickson Ambulance, LLC d/b/a ("Erickson Ambulance") is an equal opportunity employer and does not allow any unlawfully discriminatory practices associated with employment. Therefore, none of the questions on this employment application will be used for the purpose of limiting or excluding any applicant from consideration for employment as prohibited by local, state, or federal law. Equal access to employment, employee services, and programs is available to all persons. Any applicant(s) who require reasonable accommodations pertaining to the application and/or interview process should notify a representative of Erickson upon submitting the application for employment. Fields with an asterisk (*) are required.
  • Personal Information

  • EMS Credential Information

  • (BCLS/CPR)
  • (Paramedics Only)
  • Other Education, Skills and / or Qualifications for Informational Purposes

  • Check All That Apply
  • Employment History

  • Present or Last Position:
  • Input hourly wage if not salaried.
  • Input hourly wage if not salaried.
  • References

  • Reference 1
  • Reference 2
  • Authorization (Terms & Conditions)

    I hereby authorize Erickson Ambulance to contact, obtain and verify the accuracy of the information contained in this employment application from all previous employers, educational institutions and references. I also hereby release from liability Erickson Ambulance and its representatives for seeking, gathering and using such information to make employment decisions and all other persons or organizations for providing such information. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for the cancellation of this application or immediate termination of my employment when it has been or is discovered. If I become an Erickson employee, I acknowledge that there is no specific length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, I acknowledge and understand that either I or Erickson can terminate the relationship at will, with or without cause at any time so long as there is no violation of applicable federal and/or state law(s). I understand that it is the policy of Erickson not to refuse to hire or otherwise discriminate against a qualified individual by the American Disabilities Act (ADA). I also understand that if I become employed, it is my responsibility to provide satisfactory proof of identity and legal work authorization within three (3) days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment. I represent and warrant that I have read and fully understand the foregoing and that I seek employment under these conditions.
  • I represent that I have fully understood the questions above, that my answers are truthful and accurate, and that the omission of any material fact, commission of any statement, and / or any attempt to misrepresent the truth will result in immediate termination.
  • Please use your mouse as a pen within the online signature box below.
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