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United Ambulance Service
Emergency Medical Services Division
Job Application

Personal Information:

Postion Information:

Education History:

Professional Certifications:

Please fill in as much of what applies to you.



ACLS (Medics Only)

Health Care Provider CPR




Medical Priority EMD

Expiration Date:

Instructor Status:

Employment History:

Please list your last three (3) employers starting with the most recent position. Please include military experience if applicable. 

Additional Information:

This section is required for applicants with EMS Licensure ONLY.

Upload File

This Application does not create a contract for employment and all positions at United Ambulance Service are employees at will.

Applicants Certification and Agreement (Please read carefully):

By checking the box below, I certify that the answers given by me to the foregoing questions and statements are correct without consequential omissions of any kind whatsoever. I do agree not to hold United Ambulance Service liable in any respect if my employment is terminated because of falsity of statements, answers or omissions made by me in the questionnaire. I authorize nursing homes, hospitals, companies, or person’s names as former employers to give any information regarding my employment and I hereby release said employers from all liability for any damages for issuing this information.

Thank you for your application. We have received it in the Business Office.

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