CLL Application Form


Federal law obligates Centre LifeLink EMS to provide reasonable accommodation to the known disabilities of applicants and employees, unless to do so would pose an undue hardship. Please feel free to let us know if you need any accommodations to complete the application process or to perform any essential elements of the position sought.

Applicants are considered for all positions, and staff members are treated during their time of service, without regard to race, color, religion, sex, national origin, ancestry, marital status, age, disability, veteran status or any other prohibited basis of discrimination, as provided under applicable state and federal law.

Contact Information




Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate, for example, race, color, religion, sex, disability or national origin.

Employment #2

Employment #3



List the names and addresses, and telephone numbers of at least three references who are not related to you:

I certify that the information contained in this application is true and correct to the best of my knowledge and agree to have any of the statements verified by Centre LifeLink EMS unless I have indicated to the contrary. I authorize the references listed, as well as previous employers, to provide Centre LifeLink EMS any and all information concerning my previous employment and any other pertinent information that they may have. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer of employment, ability to volunteer or, if I am hired, my dismissal from employment.

I understand that this application is not a contract of employment.

I agree to conform to the rules and standards of Centre LifeLink EMS, as amended by Centre LifeLink EMS from time to time at its discretion. I further agree that I can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of Centre LifeLink EMS.

E-mail any attachments to:

Brandon McMinn, NRP Paramedic, Deputy Chief, Training Supervisor