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EMT Application Form

Please answer all questions completely and honestly. All information contained herein is considered confidential.
Personal Information
Campus Address (If Applicable)
Home Address
Other Information
Academic Information
Supplemental Information
Please list any medical or leadership volunteer or work experience below
Please provide a response of 500 words or fewer to the following question: Why do you want to be a part of UMass Lowell Emergency Medical Services?
Additional Information
References
(References cannot be family members)
Applicant Agreement
Receipt of this application and granting of an interview does not imply that the applicant will be hired. I hereby affirm that the information provided by me on this application and accompanying resume is true and complete. I understand that any false information or material omission of fact may disqualify me for further consideration for employment and may be considered justification for dismissal if discovered at a later date. I understand that any offer of employment is conditioned upon satisfactory replies from my references and a satisfactory background check. I understand that employment is for no stated term and may be terminated by UMass Lowell Emergency Medical Services or me.