Royal Ambulance - Paramedic (Per Diem)

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Paramedic Pre-Application Questionnaire

Are you at least 21 years of age?✱
- Yes
- No
Do you have an active Paramedic certification in the State of California?✱
- Yes
- No
If you answered "yes" to the question above, please list your license/certification number:
How many years of Paramedic experience do you have?✱
- 0-1 Years
- 1-3 Years
- 3-5 Years
- 5-7 Years
- 7+ Years
Have you been employed by Royal Ambulance in the past?✱
- Yes
- No
What shifts are you available for? (Select all that apply)✱
- Days
- Swing Shift
- Nights
Do you have a valid CA Driver's License?✱
- Yes
- No
Do you have a CA Ambulance Drivers Certificate?✱
- Yes
- No
Please list the certifications you have below:✱
- AHA CPR Card
- PALS/PEPP Certification
- ACLS
- International Trauma Life Support (ITLS) Certification
- Santa Clara County Badge
- None of the above
Are you able to lift 150-200 lbs with or without a reasonable accomodation?✱
- Yes
- No
What are your salary requirements? (Numbers)✱

Military Service (If Applicable)

Branch
Currently Active? If not, please fill out dates of service in the following field.
- Yes
- No
Dates of Service: (Month/Year)-(Month/Year)
Rank at Discharge:
Type of Discharge:
If other than honorable, please explain:

Referral Source

How did you hear about Royal Ambulance?✱
If you selected "Referred by a Royal Team Member" or "Other", please enter their information below:

Additional information

U.S. Equal Employment Opportunity information (Completion is voluntary and will not subject you to adverse treatment)

Our company values diversity. To ensure that we comply with reporting requirements and to learn more about how we can increase diversity in our candidate pool, we invite you to voluntarily provide demographic information in a confidential survey at the end of this application. Providing this information is optional. It will not be accessible or used in the hiring process, and has no effect on your opportunity for employment.

Gender

Race

Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American (Not Hispanic or Latino)
A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above five races.

Veteran status