Burton EMS is an equal opportunity employer. Applying takes about 10 minutes. After you submit, we'll send you to Indeed to finish.

Job you're applying for

If Other, which position?

Applicant Information

Have you worked or attended school under another name?

Yes No

If yes, list other names

Are you legally authorized to work in the U.S.?

Yes No

Proof of identity and eligibility (Form I-9) is required if hired.

Are you at least 18 years old?

Yes No

Have you ever been convicted of a crime or pleaded no contest, other than minor traffic violations?

Yes No

A conviction is not an automatic bar to employment.

If yes, nature of offense, date, and county/state

Do you have any pending criminal charges?

Yes No

If yes, please explain

Have you applied at Burton EMS before?

Yes No

Have you worked at Burton EMS before?

Yes No

If yes, when and what position?

Do you have relatives or personal relationships with Burton employees?

Yes No

If yes, names and relationship

Full-time or part-time?

Full-time Part-time Either

Preferred start date

Where did you hear about Burton EMS?

Diploma or GED?

Yes No

College / technical school

Degree earned?

Yes No

Other training or certifications

Work History (most recent first)

May we contact this employer as a reference?

Yes No

May we contact this employer as a reference?

Yes No

Certification

All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions may result in denial of employment or dismissal if hired. I authorize the company to investigate my responses and contact any former employers or individuals for verification. I release all parties from liability for providing such information. I understand that employment is at-will and may be terminated at any time by either myself or the company.

Employment Application

Applicant Information

About the Job

Education

Work History (most recent first)

Job 1

Job 2

Certification

Get a Quote Today