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75th Anniversary Gala
About Us
AHA Training
Outreach
Billing & Records
Events
- Calendar

Careers

We believe that a career in EMS has limitless potential! If you are a highly professional and patient-focused provider, we’d like to hear from you.

We accept applications on a rolling basis. We will review your application, qualifications, and experience and contact you to schedule an interview.

To apply:

Fill out the application below. You can save your progress and come back to finish it later.
Have a photo or scan of your NYS EMT certification and CPR card ready to upload. Paramedics, please also have your REMO ID, ACLS, and PALS cards.
You’re welcome to include your resume and a cover letter, too.

If you have any trouble with the form, email us at info@cphmems.org.

All application materials are held on file for 6 months.

Careers in EMS Application

"*" indicates required fields

1Contact & Position

2Training & Education

3Employment

4EMS Experience

5Background

6Service & References

7Attachments & Signature

Thank you for your interest in joining Clifton Park & Halfmoon Emergency Corps. This application replaces our PDF application, so there is nothing to download or print.

The form has several short steps. Fields marked with an asterisk (*) are required. You can save your progress and come back later using the “Save and Continue Later” link at the bottom of each step.

Contact Information

Name*

First Last

Email Address*

Phone*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

My home address is different from my mailing address

Home Address

Street Address Address Line 2 City State ZIP Code

Position Desired

Position*

Paramedic

EMT-Basic

Other

Schedule*

Full Time (36 hrs/week)

Part Time (12-24 hrs/week)

Per Diem (minimum 24 hrs/month)

When can you start?*

Have you applied here previously?*

Yes

No

EMS Education and Training

Current Level of Certification*

CFR

EMT-B

EMT-Paramedic

Other

NYS Number

NYS Number Expires

Location of Initial Basic Training

Initial Basic Training Date

Initial Basic Training Instructor

Location of Initial Advanced Training

Initial Advanced Training Date

Initial Advanced Training Instructor

Location of Most Recent EMT or AEMT Refresher

Refresher Date

Refresher Instructor

REMO (Paramedics)

Initial Date Placed On-Line in REMO

REMO #

EMS Agency Placed On-Line With

Formal Education

High School: School

High School: Address

High School: Diploma or Degree Received

College: School

College: Address

College: Diploma or Degree Received

Other: School

Other: Address

Other: Diploma or Degree Received

Employment History

Starting with your current or most recent employer, list up to three (3) employers.

Employer #1

Job Title

Employer

Date Started

Date Left

Leave blank if this is your current position.

Supervisor

Phone

Address

Hours per Week

Brief Description of Duties

Reason for Leaving

Starting Pay

Ending/Current Pay

Can you provide verification of experience?

Yes

No

May we contact for a reference?

Yes

No

Add another employer

Employer #2

Job Title

Employer

Date Started

Date Left

Leave blank if this is your current position.

Supervisor

Phone

Address

Hours per Week

Brief Description of Duties

Reason for Leaving

Starting Pay

Ending/Current Pay

Can you provide verification of experience?

Yes

No

May we contact for a reference?

Yes

No

Add another employer

Employer #3

Job Title

Employer

Date Started

Date Left

Leave blank if this is your current position.

Supervisor

Phone

Address

Hours per Week

Brief Description of Duties

Reason for Leaving

Starting Pay

Ending/Current Pay

Can you provide verification of experience?

Yes

No

May we contact for a reference?

Yes

No

EMS Experience

Starting with your most recent EMS agency, list up to three (3) consecutive places of service.

EMS Agency #1

Job Title

Employer

Date Started

Date Left

Leave blank if this is your current position.

Supervisor

Phone

Address

Hours per Week

Brief Description of Duties

Reason for Leaving

Can you provide verification of experience?

Yes

No

May we contact for a reference?

Yes

No

Add another EMS agency

EMS Agency #2

Job Title

Employer

Date Started

Date Left

Leave blank if this is your current position.

Supervisor

Phone

Address

Hours per Week

Brief Description of Duties

Reason for Leaving

Can you provide verification of experience?

Yes

No

May we contact for a reference?

Yes

No

Add another EMS agency

EMS Agency #3

Job Title

Employer

Date Started

Date Left

Leave blank if this is your current position.

Supervisor

Phone

Address

Hours per Week

Brief Description of Duties

Reason for Leaving

Can you provide verification of experience?

Yes

No

May we contact for a reference?

Yes

No

Office of Inspector General (OIG) Exclusion

Have you or an affiliated organization appeared on the OIG List of Excluded Individuals and Entities?*

Yes

No

(Excluded from federal health care program due to, but not limited to, conviction of Medicare/Medicaid fraud; patient abuse or neglect; felony convictions for other health-care related fraud.)

Americans with Disabilities Act

In order to perform the duties of this position, will you require accommodation?*

Yes

No

(Your answer will not affect your application.)

Criminal History

Have you ever been convicted of a crime other than a misdemeanor violation?*

Yes

No

(A conviction will not affect your application.)

Please explain the circumstances*

Supporting documents (optional)

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB, Max. files: 5.

Driving History

Do you have a valid NYS Driver License?*

Yes

No

Driver's License Number

License Expires

Traffic Violations, Accidents, Suspensions, or Revocations

Date

Description of Accident or Details of Violation

List any traffic violations, accidents, license suspensions, or revocations in the last five (5) years. Include the court location and fines. Leave blank if none.

Community Service / Volunteer Experience

Optional. If you have more experience than fits here, you can upload a separate page on the last step.

Organization #1

Organization

Date(s) of Service

Address

Supervisor

Phone

Brief Description of Service

Hours Served

Can you provide verification of experience?

Yes

No

Add another organization

Organization #2

Organization

Date(s) of Service

Address

Supervisor

Phone

Brief Description of Service

Hours Served

Can you provide verification of experience?

Yes

No

Personal References

List three (3) personal references, not family or living with you, that you have known for at least three (3) years.

Reference #1

Name*

Relationship*

Years Acquainted*

Please enter a number greater than or equal to 3.

Phone*

May we contact for a reference?*

Yes

No

Address

City, State

Zip

Reference #2

Name*

Relationship*

Years Acquainted*

Please enter a number greater than or equal to 3.

Phone*

May we contact for a reference?*

Yes

No

Address

City, State

Zip

Reference #3

Name*

Relationship*

Years Acquainted*

Please enter a number greater than or equal to 3.

Phone*

May we contact for a reference?*

Yes

No

Address

City, State

Zip

Attachments

Please upload legible copies of the following documents. Photos from your phone are fine. Accepted file types: JPG, PNG, PDF, or DOCX, up to 10 MB each.

NYS EMT Certification*

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB.

CPR for Healthcare Providers Card*

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB.

REMO Identification Card (ALS Providers Only)

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB.

ACLS Card (ALS Providers Only)

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB.

PALS Card (ALS Providers Only)

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB.

Additional Training Certificates

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB, Max. files: 10.

Upload Resume (optional)

Accepted file types: pdf, docx, Max. file size: 10 MB.

Upload Cover Letter (optional)

Accepted file types: jpg, png, pdf, docx, Max. file size: 10 MB.

Additional Pages (optional)

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, docx, Max. file size: 10 MB, Max. files: 5.

For example, extra employment or volunteer experience that did not fit above.

Anything else you would like us to know? (optional)

Applicant's Statement

I certify that all information provided herein is true and complete to the best of my knowledge.

I hereby authorize Clifton Park and Halfmoon Emergency Corps Inc. to make any investigations of my criminal, motor vehicle, education, and employment histories or any other related affairs as may be necessary in arriving at a membership/employment decision. I also release all persons from liabilities in responding to inquiries regarding my application.

I also hereby agree to submit to a pre-employment drug screening test and understand that a positive result for unlawful drugs may result in the withdrawal of a conditional job offer.

In the event of membership/employment, I understand that upon discovery of false or misleading information in my application or during my employment interview, may result in my discharge. I also understand that I am required to follow all rules, regulations, policies, procedures, and job requirements of Clifton Park and Halfmoon Emergency Corps Inc. and that failure to do so may result in discharge.

In place of the original, I permit a copy of this statement to be used.

Acknowledgment*

I have read and agree to the Applicant’s Statement above

Signature of Applicant*

Type your full legal name. This serves as your electronic signature.

Date*

Subject

Activity Status

Formatted Date

2024 Clifton Park & Halfmoon Emergency Corps
15 Crossing Blvd
Clifton Park, NY 12065

Phone: +1 (518) 371-3880
Email: info@cphmems.org

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