Wildland Operator / Event Medical Standby Application – Emergency Medical Services University, LLC

EMSU Wildland Operator / Event Medical Standby Application

If you are interested in contracting with EMSU and to become a Wildland Operator, fill out the following application and someone will contact you to discuss your options.

You do not need to have EMT experience to apply! If you’re a current EMSU student, this is a great opportunity to get valuable field experience under your belt. If you’ve already completed training and want to continue working in Wildland or Event Medical roles, we welcome that too. This is the perfect first step to get involved and start making a difference.

Personal Information

If you are interested in contracting with EMSU to deploy for Wildland Operations, fill out the following form below with your information and a member of our team will contact you to discuss your options.

Full Name *

Phone *

Date of Birth *

Email *

Once certified as an EMT, are you able to travel out of town for at least 2 weeks at a time per deployment? (Some Deployments May Be Shorter) *

Are you interested, once certified as an EMT, in helping provide medical standby for events? *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How Did you Hear About This Program?

Employment and Education

Current Organization *

Employment Start Date *

Degree/Diploma *

Professional Certifications *

Job Title *

Reason for Leaving (If Applicable) *

School Name *

Relevant Training or Courses *

Job Responsibilities and Achievements *

Attach Resume/CV *

Drag & Drop Files, Choose Files to Upload

Attach Cover Letter *

Drag & Drop Files, Choose Files to Upload

References

Reference 1 Name

Reference 2 Name

Relationship

Contact Information

Have you ever been convicted of a felony? *

Applicant's Signature *

Clear Signature

Date of Application *

EMS University

EMSU Wildland Operator / Event Medical Standby Application

Personal Information

Employment and Education

References

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