Employment Application

If you are interested in a career with Western Lame Ambulance, please fill out the employment form below. You can also download a pdf of the application to fill out by hand.

pdficon_largeDownload application here

Thank you!


  • Western Lane Ambulance District (WLAD) does not discriminate in hiring on the basis of gender, race, national origin, age, disability, religion, or other protected class status. WLAD is in conformity with all local, state and federal laws and regulations regarding fair employment practices.
  • Emergency Contact

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    Education and Training

  • Licence, Registration, Certificate

  • Specialized Skills and Knowledge

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    Work History

  • Give accurate, complete full time and part time employment history starting with your current or most recent job for the last ten years. You should include employment with public agencies including the U S. Government Armed Forces, etc. Attach additional pages if necessary.
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  • List four personal references. Do not include relatives or former employers.

  • List four professional references. Include persons that would have knowledge of your working skills.
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    WESTERN LANE AMBULANCE DISTRICT - Supplemental Questionnaire

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  • Western Lane Ambulance District is authorized to verify any or all of the information contained on the Application Form. A false answer to any question(s) in this application may be grounds for nonselection or for termination after you begin work. All statements are subject to investigation, including a check of your training and experience statements. All information you give will be considered in reviewing your application.

    • I hereby certify that all statements contained herein are true and complete whether made by others or me at my request.

    • I agree and understand that any misstatement, misrepresentation, falsification or omission of facts shall cause forfeiture of all rights to employment with Western Lane Ambulance District.

    • If accepted for employment, I agree to abide by and comply with all rules, regulations, policies, and procedures of Western Lane Ambulance District.

    • I further understand and agree that my employer has the right to terminate my employment during my initial probationary period without cause or notice.

    • If requested by Western lane Ambulance District, I freely and voluntarily agree to submit to a drug test as part of my application for and as a condition of employment. I understand that either my refusal to submit to the drug test or my failure to qualify according to the minimum standards stated by Western Lane Ambulance District for this examination, may disqualify me from further consideration for employment.


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