Employment Application:

NELSON COUNTY 

EMS 

Online Application

Applicants are considered for employment based on knowledge, experience, license and skills without regard to race, color, religion, sex, national origin, age, marital or veteran status, or non-job related medical condition or disability.

APPLICANT INFORMATION:
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KBEMS Licensure or Certification Number:
NREMT Licensure or Certification Number:
Are you a citizen of the United States?
If no, are you authorized to work in the U.S.?
Have you ever worked for this company?
Have you ever been convicted of a felony?
EDUCATION
Did you graduate? 
Did you graduate? 
Did you graduate? 
REFERENCES (Please list three professional references)
PREVIOUS EMPLOYMENT
May we contact your previous supervisor for a reference?
May we contact your previous supervisor for a reference?