**** Next EMT / EMR Refresher in April ****

Employment Application

Employment / Volunteer Application

  • This application is considered part of the employment process, and MUST be fully completed. Incomplete applications may be rejected. Be brief, but you should include all important information related to your qualifications for this position. All statements are subject to investigation and any facts found to be false, exaggerated or misleading may result in your disqualification.

    NOTE: Discrimination because of race, color, sex, sexual orientation, religion, age disability, or veteran's status is prohibited by law.

  • Licenses & Certifications

    Please list all EMS Related licenses, certifications, or other credentials that you CURRENTLY hold or will obtain by date of hire.
  • Education:

  • Military:

  • Volunteer Experience:

    Please list any experience that you have had volunteering, this should also include any interaction with Emergency Service Volunteers. Understand that as part of this job it is highly likely that you will be working with volunteers at WVA as well as other Town of Windsor agencies that consist of volunteers.
  • Personal References

    Excluding relatives and previous employers. List three (3) individuals.
  • Professional References:

    In the spaces provided below, please provide us with the names and contact information of three (3) professional references.
  • Experience:

    In the spaces provided below, give a complete record of your employment, beginning with your present or most recent job. Account for all periods, including self-employment.
  • Are there any other experiences, skills, or qualifications which will be of benefit in the job you are applying for? If so, please explain below:
  • IMPORTANT - READ THE INFORMATION BELOW AND SIGN YOUR APPLICATION

  • My signature below certifies that the information provided in this application is correct and truthful. I realize that falsifying any information submitted may be grounds for rejection of this application or termination of employment. I also give consent to Windsor Volunteer Ambulance to check previous employers, educational records, motor vehicle records and references and release Windsor Volunteer Ambulance, its agents and employees from any liability that might arise from such disclosures. I further understand the acceptance of this application does not constitute a employment or volunteer agreement. Failure to completely fill out this application may result in my disqualification from any further consideration for employment.

    I ACKNOWLEDGE THAT I HAVE READ THIS INFORMATION AND THAT I UNDERSTAND THE REQUIREMENTS FOR EMPLOYMENT OR VOLUNTEERING WITH WINDSOR VOLUNTEER AMBULANCE.

    Print, sign, and mail application to the address below with all supporting documents and copy of certifications.

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