223 Henry Avenue
Manchester, Missouri 63011-4017
* a conviction will not necessarily be a bar to employment; factors such as age at time of offense, seriousness and the nature of the violation and rehabilitation will be taken into consideration.
List three persons who are NOT related to you and have definite knowledge of your qualifications
and skills for the position for which you are applying. (Recent graduate, please list instructors.)
List any professional, trade or service organizations in which you are a member, if you think
such participation would be helpful to us in considering you for employment (e.g., organizing
activities, additional work experience, accomplishments, leadership, etc...).
It is understood that the submission and consideration of this application is not an obligation
on behalf of West County EMS & Fire to provide employment.
I hereby authorize West County EMS & Fire to investigate the information contained herein,
and I hereby release all references, previous employers and educational institutions from
damages resulting from providing such information.
West County EMS & Fire has adopted a Drug-Free Workplace/Workforce policy. In
compliance with this policy I understand that I may be required, either before or any time
after employment, to submit to urine testing, hair testing and/or other medical examination
for controlled substance abuse and/or illegal drug use. Said testing and/or examination will
be conducted by a health facility, medical or testing clinic or laboratory, or physician as
selected and paid for by West County EMS & Fire. I further acknowledge and understand
that, should such test results show the presence of controlled substance abuse and/or illegal
drug use, emplyment with West County EMS & Fire may be denied or terminated.
I understand that, if employed by West County EMS & Fire, I will be subject to the terms of
the employer's policy for the maintaining of a Drug-Free Workplace/Workforce policy.
Therefore, I hereby agree to sign any documents deemed necessary to permit the release of
and disclosure to West County EMS & Fire of any testing and/or medical examination for
controlled substance abuse or illegal drug use.
I agree to provide proof of my eligibility to work as required by The Immigration Reform and
Control Act of 1986.
I understand that this employment application and any other employment documents are not
contracts of employment, and that if hired, I may voluntarily leave employment and may be
terminated by West County EMS & Fire at any time for any reason.
I certify that any and all information contained in t his application and the accompanying
resume is correct and complete to the best of my knowledge and belief. I agree that I have
read and understand the above acknowledgements and agreements and recognize all of the
above as conditions of employment.
West County EMS & Fire IS AN EQUAL OPPORTUNITY EMPLOYER. It is the policy of
West County EMS & Fire that all applicants for employment shall be given fair and equal
consideration, regardless of race, religion, color, gender, age, sexual orientation, disability,
veteran status or national origin, except that minimum age limits imposed by law are to be
observed. If selected for employment, a prospective employee must provide satisfactory
references for the firm and meet our applicable pre-employment qualifications.