Employment

Application

Upon completion of the following application, please email your resume to [email protected] or fax your resume to 281-489-0024.

Name *

First

Last

Address *

City *

State *

Phone Number *

Email *

Do you have the legal right to reside and work in the United States? *

Have you ever been dismissed and/or allowed to resign in lieu of discharge? *

Have you ever been convicted of a felony? *

Texas State Certification *

Certificate Number *

Certification Expiration Date *

Years in EMS *

Years at Current Certification Level *

Years in 911 at Current Level *

Education Information *

Please include the highest level of education you have completed, the last educational institution you attended, and the degree/Certification(s) you have obtained.

Current Employer *

Please include the name of your current employer, your supervisor's name/title, your position, the duties of your position, your dates of employment, your reason for leaving and the address and telephone number of your current employer.

Previous Employer *

Please include the name of your previous employer, your supervisor's name/title, your position, the duties of your position, your dates of employment, your reason for leaving and the address and telephone number of your previous employer.

Previous Employer *

Personal References *

Please list the name, address, phone number and email of 3 personal references.

Phone

Brazoria County
Emergency Services District No.3
6931 Masters Rd / P.O. Box 1253
Manvel, Texas, 77578
Monday – Thursday 9 a.m – 4 p.m.
Friday – by appointment only

[email protected]

Phone : 281-519-8779
Fax : 281-489-0024

EMPLOYMENT

Application