Job Application

Contact Info


Work Availability


EMT Certifications & Licenses


Criminal Background


Employment Details

    Desired Position

  • Current Employment



    High School

  • College

  • Other Training

  • Additional Experience


Work Experience

  • Company #1

  • Company #2

  • Company #3

  • Company #4



    Reference #1

  • Reference #2

  • Reference #3


Submit Application

  • I certify that all information provided by me on this application is true and complete to the best of my knowledge and that I have withheld nothing that, if disclosed, would alter the integrity of this application.

    I authorize my previous employers, schools, or persons listed as references to give any information regarding employment or educational record. I agree that this company and my previous employers will not be held liable in any respect if a job offer is not extended, or is withdrawn, or employment is terminated because of false statements, omissions, or answers made by myself on this application. In the event of any employment with this company, I will comply with all rules and regulations as set by the company in any communication distributed to the employees.

    In compliance with the Immigration Reform and Control Act of 1986, I understand that I am required to provide approved documentation to the company that verifies my right to work in the United States on the first day of employment. I have received from the company a list of the approved documents that are required.

    I understand that employment at this company is “at will,” which means that either I or Ohio Medical Transport, LLC can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I hereby acknowledge that I have read and understand the above statements.


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