Skip to content
Toggle Navigation
Home
About
Careers
APPLY NOW
Training
Contact
Forms
262-335-2911
Toggle Navigation
Home
About
Careers
APPLY NOW
Training
Contact
Forms
262-335-2911
Application Form
Application Form
lifestarems
2022-01-12T14:40:54+00:00
Please fill out the Application Form below.
"
*
" indicates required fields
Full Name:
*
Address:
*
Address Line 1
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Phone:
Email:
*
Are you legally authorized to work in the United States?
*
Yes
No
Have you previously applied for a job at Lifestar?
*
Yes
No
If Yes, when?
Have you previously worked at Lifestar?
*
Yes
No
If Yes, when?
Position Applying For:
*
EMS License Level:
Wisconsin EMS License #:
Type of Employment Applying For:
*
Full-Time
Part-Time
Seasonal
Intern
Preferred Location:
*
Were you referred by a Lifestar employee?
*
Yes
No
If Yes, enter name of employee:
Lifestar is an Affirmative Action/Equal Employment Employer and as such, we are required to collect and maintain information related to applicants in order to meet governmental recordkeeping and reporting requirements and to monitor the effectiveness of our outreach, recruitment and other employment practices. At this time, we are asking you to help us meet our obligations by providing the information listed below. Please note that the information will be used only in accordance with the provisions of applicable laws, executive orders, and regulations. Providing this information is voluntary and refusal to so will not result in any adverse treatment. The information you provide will be held in strict confidence.
Hidden
Gender:
Please select...
Male
Female
Prefer Not To Say
Hidden
Ethnicity:
Please select...
Hispanic or Latino (a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race)
Not Hispanic or Latino (please address race below)
I choose not to disclose this information
Hidden
Race:
Please select...
White (not Hispanic or Latino)
Asian
American Indian or Alaska Native
Black or African American
Native Hawaiian or other Pacific Islander
Two or More Races
I choose not to disclose this information
Hidden
Are you a protected veteran?
Yes
No
Please list any accommodations you may require:
Please upload your resume in either a PDF or Word format:
*
Max. file size: 10 MB.
Page load link
Go to Top