Employment

Windsor EMS is accepting applications for the position of full-time and Per Diem Paramedic and EMT. The ideal candidate should have minimum 2 years of active medical control and transport experience. Apply today! For more information email questions@windsorctems.com

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.
Position*
- Volunteer EMT
- Full Time Paramedic
- Per Diem Paramedic
- Full Time EMT
- Per Diem EMT
Applicant's Name*
First Last
Any Previous Name Used by Applicant
Home Address*
Street Address City State ZIP Code
Mailing Address (if different from home address)
Street Address City State ZIP Code
Cell Phone*
Home Phone
Email*
Immediate Past Three (3) Legal Addresses:*
Driver's License Number*
State:*
Have you ever been fired or asked to resign from a job?*
- Yes
- No
Please explain
Avaiilability
- Weekend Days
- Weekend Nights
- Weekday Days
- Weekday Nights
- Some Holidays
Licenses & Certifications
Please list all EMS Related licenses, certifications, or other credentials that you CURRENTLY hold or will obtain by date of hire.
Name of License or Certification
Number (if applicable):
Date Granted
Expiration Date
Name of License or Certification
Number (if applicable):
Date Granted
Expiration Date
Name of License or Certification
Number (if applicable):
Date Granted
Expiration Date
Name of License or Certification
Number (if applicable):
Date Granted
Expiration Date
If Paramedic enter most recent Medical Control Sponsor Hospital:
Date Granted
Have you operated with at least 2 years of Paramedic level medical control?*
- Yes
- No
Do you currently have medical control to operate as a paramedic?*
- Yes
- No
Have you ever had your medical control revoked due to patient care issues?*
- Yes
- No
Explain
Education:
Please mark the highest educational level received*
- Some High School
- GED
- Graduated High School
- Some College
- Graduated College
If attended college, what was your degree in?
Highest Degree Earned
College (Name, City, State)
Military:
Branch
Highest Rank
Date Enlisted
Were you honorably Discharged?
- Yes
- No
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.
1. Organization Name
Address
Organization Phone Number
Supervisor
Your Job Title
Reason for Leaving
Dates You Worked There
2. Organization Name
Address
Organization Phone Number
Supervisor
Your Job Title
Reason for Leaving
Dates You Worked There
3. Organization Name
Address
Organization Phone Number
Supervisor
Your Job Title
Reason for Leaving
Dates You Worked There
Personal References
Excluding relatives and previous employers. List three (3) individuals.
Name of Personal Reference #1
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Name of Personal Reference #2
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Name of Personal Reference #3
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Professional References:
In the spaces provided below, please provide us with the names and contact information of three (3) professional references.
Professional Reference Name #1
First Last
Phone
Email
Professional Reference Name #2
First Last
Phone
Email
Professional Reference Name #3
First Last
Phone
Email
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.
Employer #1
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Your Job Title
Dates of Employment
Annual Salary
Employer #2
Address
Street Address City State ZIP Code
Phone
Your Job Title
Dates of Employment
Annual Salary
Employer #3
Address
Street Address City State ZIP Code
Phone
Your Job Title
Dates of Employment
Annual Salary
Experiences, Skills, or Qualifications
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
Do you understand that as part of the testing process you will be required to submit to a thorough background investigation and a physical fitness test, a physical examination and drug test?*
- Yes
- No
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.
By checking this box, you acknowledge that all information entered is true and accurate:*
- I agree
Signature*
Email*
Date*
MM
DD
YYYY

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Employment

Employment / Volunteer Application

Licenses & Certifications

Education:

Military:

Volunteer Experience:

Personal References

Professional References:

Experience:

IMPORTANT - READ THE INFORMATION BELOW AND SIGN YOUR APPLICATION