EMS credential information
Proof of credential information is required as part of the application process since they are a mandatory requirement for EMS employment pursuant to M.G.L. 111C, 105 CMR 170.000.
If you answered that you completed collage or technical training please list your degree(s) or certificate(s) here.
Licenses, Certificates, Job related Training or Other Training. Please enter any and all here.
(Please do not include relatives and/or current employers)
MOST RECENT EMPLOYMENT
Provide the following information for your current and/or past two employers.
PREVIOUS OR OTHER RECENT EMPLOYMENT
I hereby authorize EasCare to contact, obtain and verify the accuracy of the information contained in this employment application from all previous employers, educational institutions and references. I also hereby release from liability EasCare and its representatives for seeking, gathering and using such information to make employment decisions and all other persons or organizations for providing such information. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for the cancellation of this application or immediate termination of my employment when it has been or is discovered. If I become an EasCare employee, I acknowledge that there is no specific length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, I acknowledge and understand that either I or EasCare can terminate the relationship at will, with or without cause at any time so long there is no violation of applicable federal and/or state law(s). I understand that it is the policy of EasCare not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the American Disabilities Act (ADA). I also understand that if I become employed, it is my responsibility to provide satisfactory proof of identity and legal work authorization within three (3) days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.
I represent and warrant that I have read and fully understand the foregoing and that I seek employment under these conditions.
Please answer the following questions honestly and accurately. The omission of any material fact, the commission of any false statement, and/or any attempt to misrepresent the truth will result in immediate termination. Furthermore, to knowingly make an omission of a material fact or false statement is in violation of 105 CMR 170940: Grounds for suspension, Revocation of Certification, or Refusal to renew Certification and will be forwarded to the Department of Public Health (Department), office of Emergency Medical Services (OEMS) for investigation.
Any answer in the affirmative will be reviewed and assessed. Based on said statement. A decision will be made relative to whether or not you are eligible for hire. An answer in the affirmative will not automatically exclude you from an employment opportunity.
If you require assistance in answering any of the following questions, please tell the manager on duty. It is essential that you understand what is being asked of you.
I represent that I have fully understood the following questions, that my answers are truthful and accurate, and that the omission of any material fact, commission of any false statement, and/or any attempt to misrepresent the truth will result in immediate termination. I further understand that knowingly making an omission of a material fact or a false statement is in violation of 105 CMR 170940: Grounds for Suspension. Revocation of Certification, or Refusal to Renew Certification and said issue will be forwarded to the Department of Public Health (Department), Office of Emergency Medical Service (OEMS) for investigation.
Thank you for taking the time to apply with EasCare. Please note that only those with whom we wish to interview will be contacted for an interview.