WEST COUNTY EMS & FIRE
PROTECTION DISTRICT

223 Henry Avenue
Manchester, Missouri 63011-4017

Application For Employment
Paramedic/Firefighter

Important Hiring Notice

Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other factor which is prohibited by Missouri or Federal law. The District is an equal opportunity employer. This application will be considered active for only 60 days from the date on which you submit it. If you wish to be considered for employment after that time, you must submit a new application. Please complete the application in its entirety. You must complete your own application.

Address






Employment





Employment is, of course, subject to verification of authorization to work in the United States.
Give accurate, complete full-time and part-time employment history starting with your present or most recent employer.
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Questions Indicate Yes/No If Yes, Please Provide Explanation
Have you ever been disciplined, asked to resign, or discharged from employment?
Have you previously applied for work with the District?
Are you related to anyone who currently (or in the past) worked for the District?
Have you ever served in the military?
Are you able to perform the essential functions of the job for which you are applying, either with or without a reasonable accommodation?
Have you ever been convicted of a felony crime, or a crime involving dishonesty or lack of truthfulness or involving a health service function or organization? (Include any SIS, probation, guilty plea, plea of nolo contendere, etc. all are considered convictions)*

* 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.)


Education

School Name Location Years Completed Degree or Diploma Area of Specialty
High School
College/University
Graduate School
Trade/Professional
EMT/Paramedic
St. Louis County Fire Academy
MUST HAVE COMPLETED

Additional EMS Education

Course
(if applicable)
Where Attended Date Completed Current
ACLS
PHTLS/BTLS
PALS
CPR




Additional Fire Education

Course Where Attended Date Completed

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...).


Copy of Cover Letter/Resume

We accept .pdf or .jpg files.

Copy of High School Diploma or GED

We accept .pdf or .jpg files.

Copy of Valid Missouri Paramedic License

We accept .pdf or .jpg files.

Copy of St. Louis County Fire Academy Certificate

We accept .pdf or .jpg files.

Copy of Valid CPAT Card

We accept .pdf or .jpg files.

Copy of Current ACLS Card

We accept .pdf or .jpg files.

Copy of Current PALS/PACTS Card

We accept .pdf or .jpg files.

Copy of Current PHTLS/BHTLS Card

We accept .pdf or .jpg files.

Copy of Current CPR Card

We accept .pdf or .jpg files.


CERTIFICATION AND ACKNOWLEDGEMENT OF UNDERSTANDING

Please read carefully

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.