Med-Van Employment Application

Please take the Time and Complete the On-Line Application. We are currently seeking EMT's, Paramedics, Drivers and Administrative Staff. Med-Van Offers; Competitive Wages, Vacation / Sick Time, Uniform Allowance and Health Insurance. Hiring Employees for the Following Counties: Blair, Cambria and Indiana. Immediate Positions: DISPATCHER / BILLING, PARA-TRANSIT DRIVERS

Position Desired: *

Multiple Selections allowed. Hold down the CONTROL key when clicking to select multiple items.

Date: *

Your E-MAIL Address: *

Full Name: *

Street Address: *

City, State, Zip: *

Contact Number: *

Alternate Phone Number:

Drivers License Number: *

SS#: *

Over 21 years of Age?: *

Are you Legally allowed to work in this Country?: *

Are you currently Employed?: *

May we contact your current Employer?: *

On what date are you available to work?: *

Text and Numeric allowed!

Are you currently on layoff status and subject to recall?: *

Are you able to travel if the job requires it?: *

Have you been convicted of a Felony or Misdemeanor in the last 7 years?: *

If YES, Please explain!:

Conviction will not necessarily disqualify an applicant from employment.

Are you physically or otherwise unable to perform the duties of the job you are applying for?: *

Med-Van is an equal opportunity employer!

Previous Employment: *

Start with your present or last job. Please include the following; Company Name, Address, Phone Number, Dates of Employment, Position, Contact Person, Reason for Leaving.

Please list Special Skills and Qualifications. : *

Summarize special job-related skills and qualifications acquired from employment or other experience. Also list any additional Licenses or Certifications.

Personal list 3 Professional References.: *

Please list at least 3 Professional References. Provide the following information; Name, Address,Phone Number and Relationship,

Please Read the following and press submit when completed: *

I Certify herein that the answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

The Applicant understands that neither this document or any offer of employment from MED-VAN TRANSPORT constitutes an employment contract unless a specific document to that effect is agreed to by the employer and the employee in writing.

In the event of employment, I understand that false or misleading information given in my application or interview, may result in immediate discharge. Furthermore, I understand I am recquired to abide by all rules and regulations of MED-VAN TRANSPORT.

If completed and please select acknowledgement below then press the SUBMIT BUTTON, therefore accepting the above statements.