Join Our Team - North Fork EMS

Application Information

On-Call Positions open:

On-Call Driver - To become a Driver for us, you must have a Colorado Drivers License in good standing and hold, or be willing to obtain, a BLS for Healthcare Provider CPR card. Your NF EMS Orientation Training will prepare you for this role. Joining us as a Driver can lead to becoming an EMT with funding provided.
On-Call EMS Provider - To join us at your level of certification requires a State of Colorado EMS provider certification. Levels accepted: EMT, EMT-IV, AEMT, EMT-I, and Paramedic.

On-Call Shifts and Pay:

You are able to schedule shifts to fit your schedule
Minimum requirement of forty-eight 12-hour shifts per year to maintain Active Status
You are required to respond to the station and be enroute with your partner within 10 minutes of the 911 page
There are stations with accomodations in Crawford, Hotchkiss and Paonia
Day shift: 6 am to 6 pm
Night shift: 6 pm to 6 am
Many NF EMS providers run an average of eight to sixteen 12-hours shifts per month, depending on schedule availability
Pay ranges from $105 to $165 per 12-hour shift depending upon your level of certification

Upon receipt of your completed application we will schedule an interview with you. This is a time to get your questions answered and determine if this is a good fit for you and North Fork EMS.

If hired, the employee must complete Orientation and meet certain requirements in order to take On-Call shifts with North Fork EMS.

North Fork EMS New Hire Requirements

Pre-employment drug screen prior to Orientation
All employment paperwork completed
Orientation and hands-on training

To Apply: Please fill out the form below. If you would like to fill out a paper copy, please contact our Business Office at 970-872-9111.

"*" indicates required fields

Applicant Information:

Name:*

First Middle Last

Date of Birth:*

Age:*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Date Available:*

Social Security #:*

Position applied for:*

Current CPR for Healthcare Professionals?*

Expiration Date:*

EMS Certification Level:

EMS Certification Number:

Current National Registry?

Number:

Have you ever had your EMT certification revoked or suspended?*

Yes

If yes, please explain:*

Drivers License Information:

Do you have a current State of Colorado Driver's License?*

Yes

If you do not have a current Colorado Driver's License, you will need to obtain one withing 60 days.

Current Driver's License Number:

What classification do you hold?

CDL-A

CDL-B

Has your license been suspended, revoked or cancelled within the past year?*

Yes

In the past year, have you received a moving violation?*

Yes

How many citations/summons?*

Have you ever been arrested for and/or convicted of Driving Under the Influence (DUI) of Alcohol and/or Drugs?*

Yes

Comments/Explanation for above driving issues:*

Are you a citizen of the United States?*

Yes

If no, are you authorized to work in the U.S.?*

Yes

Have you ever worked for this company?*

Yes

When did you work for this company?*

Have you ever been convicted of a felony?*

Yes

Please explain your conviction:*

Education

High School

Address:

From:

To:

Did you graduate

Yes

Diploma

College:

Address:

From:

To:

Did you graduate

Yes

Degree:

Other education:

Address:

From:

To:

Did you graduate

Yes

Degree:

References:

Please list two or three professional references:

Reference Name:*

First Last

Relationship:*

Company:*

Phone:*

Address*

Street Address Address Line 2 City State ZIP Code

Reference Name:*

First Last

Relationship:*

Company:*

Phone:*

Address*

Street Address Address Line 2 City State ZIP Code

Reference Name:

First Last

Relationship:

Company:

Phone:

Address

Street Address Address Line 2 City State ZIP Code

Previous Employment

Company

Phone

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Supervisor

Job title

Responsibilities

From:

To:

Reason for leaving:

May we contact your previous employer for reference?

Yes

Military Service

Branch

From:

To:

Additional details

Why do you want to work at North Fork EMS?

What can you bring to North Fork EMS?

Disclaimer and Digital Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I consent and give North Fork EMS permission to perform reference checks and a background check.

Name*

First Last

Date*

Signature*

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Phone

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