SCEMS Employment Application Fields noted with an asterisk (*) are REQUIRED fields Position Applying for * EMT AEMT Paramedic Fleet Mechanic Fleet Manager Part time or Full time? * Part time Full time Either - Full time or Part time Last Name * last name First Name * first name Middle Initial * middle initial Email * email Street address * street City * city State * state Zip Code * zip Home phone * home phone Cell phone * cell SSN (optional) ssn Date first available if employment offer is made? * Salary range desired * Are you at least 18 years old? * Yes No Are you a U.S. citizen? * Yes No If not a U.S. citizen, are you eligible for lawful employment in the U.S.? (proof of identity, citizenship or legal right to work in the U.S. will be required upon hiring) Yes No Have you ever been arrested or convicted of any law violation other than traffic violations? * Yes No If yes, please explain (date, place, charge, disposition) High school (Name, City, State, Graduation Year) * College (Name, City, State, Graduation Year) Trade School (Name, City, State, completion year) Are you licensed to practice in any profession? * Yes No If yes, list profession, license number and expiration date Has your professional license ever been revoked or suspended? * Yes No Not applicable If yes, please explain Military Service - Branch, Dates (To/From), Kind of Discharge Explain any special military schooling received that would assist you to fulfill this position Current or most recent employer name Current or most recent employer position Current or most recent employer dates of employment Current or most recent employer salary Reason for leaving (if applicable) Please list the names of other previous employers along with dates of employment Knowledge, skills and abilities relevant to the position in which you are applying Additional information that could help you qualify for this position Reference #1 (Name, City, State, Phone #) * Reference #2 (Name, City, State, Phone #) * Reference #3 (Name, City, State, Phone #) * Reference #4 (Name, City, State, Phone #) You can also email your resume to Assistant Chief Jay Austin @ jayaustin@sumnerems.org I understand that any false answer or statement made by me on this application or any supplement that I have attached, or in connection with my application for employment with any department of Sumner County Government will be sufficient grounds for rejection of my application or immediate dismissal if I am employed. I certify that all information listed on my application is complete and accurate to the best of my knowledge. I further understand that I will not be given any opportunity to update my previous experience declarations after I have been employed. I hereby authorize Sumner County Government and its agents to conduct a thorough investigation of my background, including past employment, and agree to cooperate. I hereby release from liability all persons, companies, institutions or corporations supplying information requested pursuant to this application. I certify that the disclosures I have made are true and correct. I also understand that failure to immediately update any information provided on this application shall subject me to discipline, up to and including nonhire, for providing false information on an employment application. * By checking this box, you are certifying that you agree with the statement above reCAPTCHA If you are human, leave this field blank. Submit Application Δ
