Careers
Employment/Volunteer Application
Employment/Volunteer Application
Applicant Information
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*
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Employment Position Information
Employment Desired
*
Choose One
Full-Time
Part-Time
Full or Part-Time
Volunteer
Position applying for:
*
Choose One
Community Paramedic
EMT
FF/EMT
AEMT
FF/AEMT
Paramedic
FF/Paramedic
Volunteer
If hired, on what date can you start?
*
If needed, are you available to work overtime?
*
Yes
No
Please list current certifications (FF, EMT, AEMT, Paramedic):
*
Personal Information
Are you a U.S. citizen or approved to work in the United States?
*
Yes
No
Will you consent to a mandatory controlled substance test?
*
Yes
No
Have you ever been convicted of a criminal offense (felony or misdemeanor)?
*
Yes
No
Please state the nature of the crime(s), when and where convicted and disposition of the case(s).
Background Check
Do we have your permission to perform a background check?
*
Yes
No
Driving Record
Do we have your permission to perform a driving record check?
*
Yes
No
Social Security Number
Drivers License Number and State
Do you have any conditions which would require job accommodations?
*
Yes
No
Note: HCESD #2 / Lumberton Fire & EMS complies with ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.
If yes, please explain required accommodations.
Education and Skills
*
Military History
Are you a member of the Armed Services?
*
Yes
No
In what branch did you enlist?
Rank when discharged:
Years Served
Discharge Status
Choose One
Honorable
Dishonorable
Employment History
Employer name
*
Employer phone
*
Job Title
*
Supervisor name
*
Dates employed
*
Reason for leaving
*
Employer name
*
Employer phone
*
Job Title
*
Supervisor name
*
Dates employed
*
Reason for leaving
*
Employer name
*
Employer phone
*
Job Title
*
Supervisor name
*
Dates employed
*
Reason for leaving
*
References
First and Last Name
*
Phone
*
First and Last Name
*
Phone
*
First and Last Name
*
Phone
*
Do we have your permission to check your references?
*
Yes
No
Resume
Drop Resume here or click to upload
Choose File
Maximum upload size: 516MB
If you are human, leave this field blank.
Submit
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