Gerber Ambulance Service
Online Employment Application

Division LA County Orange County Other:

Position EMT Paramedic CCTN Dispatcher Other:

 

General


 Last Name:
 First Name:   MI:
 Address:
 City: State:
 Zip:
 Phone:
 Email:

 

Education

School
Major/Area of Study
   High School or Equivalent
   EMT
   Paramedic
   Nursing
   

 

Work Experience

List all current and previous work experience for the last ten years. Use the text box for additional information and experience.

Employer/Address
Position/Type of Business
Supervisor/Phone Number
Start Date/End Date

Additional Information:

 

 

Certifications

Check all that apply

BCLS for Healthcare Providers PALS Provider
ACLS Provider LA County Paramedic Accreditation
Ambulance Driver's Certificate State of CA EMT Certificate
State of CA Nursing License Medical Examiner's Certificate
Other: State of CA Paramedic License

 

References

Name
Relationship
Phone
     
     
     

 

Are you available to work (Check all that apply):

Nights Weekends Holidays Part-Time Full-Time

Are you a graduate of the Gerber Fast-Track Program?

Yes No

Do you have a reliable method to ensure that you will arrive for work on-time?

Yes No

Have you ever been convicted of a felony?

Yes No

If yes, explain:

 

Where did you hear about our organization?

 

All ambulance operations positions require the performance of strenuous physical activity in unfavorable weather conditions, darkness, cramped spaces, etc. To the best of your knowledge, are you physically capable of completing these tasks?

Yes No

 

Authorization

I certify that the facts contained in this application are true and complete to the best of my knowledge. I also understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements, references, and previous employment above to give you any and all information and any pertinent information that I may have, personal or otherwise. I also release Gerber Ambulance Service from all liability and damage that may result from the utilization of such information.

By submitting this form, you are agreeing to the statements presented on this page.

 

Questions/Comments? Email: jobs@gerberambulance.com

Gerber Ambulance Service does not discriminate on the basis of race, creed, religion, belief, or sex. All applicants are afforded an equal opportunity to attain all positions identified in this announcement. Applicant IP address logged for verification. Produced by Gerber Ambulance Service, January 2000, Copyright 2000 - All Rights Reserved.
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