Application for Employment

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Your application will not be submitted until all 7 sections are completed.


1. Personal Information

* denotes required fields


Identification
* First Name:
Middle Name:
* Last Name:


Present Address
* Street Address:
* City:
* State:     * Zip Code:


Permanent Address
Check if same as Present Address:   
* If different, the following fields are required:
Street Address:
City:
State:     Zip Code:


Telephone and E-mail
* Day:     Check if same as Evening:   
* Evening:
E-mail:


Employee Information


* Have you ever worked at, or applied to, Fallon Ambulance?

  Yes   No

If Yes, please list the dates and positions:

* Do you have any relatives who are present or former employees of Fallon Ambulance?
  Yes   No
If Yes, please list their names and locations:


Eligibility


* Are you legally eligible for employment in the United States?
  Yes   No

Note: Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver's license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result immediate employment temination.



Referrals


How were you referred to Fallon Ambulance?

 



Fallon Ambulance Service is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sexual orientation, gender, color, race, national origin, religion, marital status, veteran status, or disability that does not prohibit performance of essential job functions. Fallon Ambulance Service will make a reasonable accommodation to known physical or mental limitations of a qualified applicant with a disability, unless the accommodation will impose an undue hardship on the operation of our business.