Job Application

Please fill out the following fields and attach your resume below. You MUST have a valid Wyoming state EMS license. You MUST be 21 years or older. Our hiring team will contact you after we receive your submission.

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone Number (best contact number)*

Email*

Position Applying For

Are you currently Licensed in the State of Wyoming

Yes No

You must have a current Wyoming license

If Yes please enter your license number

Employment Desired*

Full-time Part-time Either

How man hours can you work weekly?

Can you work nights?*

Yes No

Are you 21or older?*

Yes No

You must be 21 years old to apply

Have you ever been convicted of a felony?*

Yes No

Have you had a DUI in the last 5 years?*

Yes No

Do you have a clean driving record for the last 5 years?*

Yes No

If yes, to any of the above questions, please explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Upload your resume*

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Upload a cover letter (optional)

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