Apply Online NowFill out and submit the online application below, or click here to download a printable version.Apply Online Now If you are human, leave this field blank. First Name * MI * Last Name * Age * Date of Birth * Email * Phone (Cell) * Phone (Other) Address * City * State * -- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip * EMT Level - Select One - Basic Advanced Paramedic EMT License # EMT License Expiration Valid DL? * Yes No DL Issued select state AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY DL # DL Expiration Position Applying For * E.M.T. Basic Driver E.M.T. Advanced E.M.T Paramedic Wheel Chair Transport Driver Body Transport Driver Dispatcher Billing SpecialistCheck here for job qualifications before submitting application.Preferred Status * Part Time Full Time Available to Begin Work * Desired Hourly Pay Have you worked for Newman’s Ambulance before? If so, give details of your reason for leaving: * Personal References Name 1 * Address 1 Phone 1 Years Acquainted Name 2 * Address 2 Phone 2 Years Acquainted Name 3 * Address 3 Phone 3 Years Acquainted Previous EmploymentList the last 3 employers, starting with the most recent: Employer #1 Length of Employment Time Period Months Years From To Contact Person Position Phone Reason for Leaving Employer #2 Length of Employment Time Period Months Years From To Contact Person Position Phone Reason for Leaving Employer #3 Length of Employment Time Period Months Years From To Contact Person Position Phone Reason for Leaving Have you been convicted of a felony? * Yes NoEducational Background Name of High School Year Start * Year End * High School Graduate * Yes NoHigh School Diploma * Yes No Name of College Year Start Year End Graduate College Yes No Degrees Acquired Other Schools Attended Year Start Year End Graduate Yes No Degrees Acquired *I certify that the facts contained in this application are true and complete to the best of my knowledge. If this application leads to employment, I understand that falsified statements on this application shall be grounds for dismissal. I understand and agree that, if hired, my employment is for no definite period and may be terminated at any time without prior notice. Yes * By checking this box and typing my name below, I am electronically signing my application. Yes Electronic Signature * Submit