Montgomery County Ambulance Job Application – Montgomery County Ambulance

MONTGOMERY COUNTY, PENNSYLVANIA
EMERGENCY MEDICAL SERVICES COMMON EMPLOYMENT APPLICATION

This Common Employment Application is a joint project between the Montgomery County Department of Public Safety and the
Montgomery County Ambulance Association. All applications will be forwarded to individual EMS agencies within Montgomery
County, Pennsylvania. Employment is not being offered by the County of Montgomery or the Montgomery County Ambulance
Association.
Please read all four (4) pages of this application and complete fully. An incomplete application will be returned
to you. The original application must be sent electronically using the SUBMIT MY APPLICATION button on page 4.

Date:

Name:

(Last)

(First)

(Middle Initial)

Address:

(Street)

(City)

(State)

(Zip Code)

Telephone number (including area code):

ONLY if under the age of 18, state your date of birth:

E-mail Address:

All Montgomery County EMS agencies accepting this Common Application comply with the Civil Rights Act of 1964 prohibiting discrimination in employment practice because
of race, color, religion, sex or national origin; PL 90-202 prohibiting discrimination because of age, and the Americans with Disabilities Act of 1992, prohibiting
discrimination against the handicapped in employment or the provision of services.

It is the policy of all Montgomery County EMS agencies accepting this Common Application to prohibit discrimination and harassment of any type and to afford equal
employment opportunities to current employees and applicants, without regard to race, color, religion, sex, national origin, age, disability, genetic information, veteran status,
marital status, sexual orientation, gender identity or expression, pregnancy or political affiliations.

All Montgomery County EMS agencies accepting this Common Application are equal opportunity employers.

Montgomery County
Department of Public Safety