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Weekly SUPERVISOR APPLICATIONSpring 2017Supervisors are vital assets to the Illini EMS Operations Department who promote quality patient care and safety. Please read through the entire application prior to submission.Qualifications1.) All applicants must hold a current and valid CPR card. Either an American Heart Association BLS for Healthcare Providers card or an American Red Cross CPR for the Professional Rescuer card will satisfy this requirement.2.) All applicants must hold a current and valid State of Illinois EMT-Basic, EMT-Intermediate, or EMT-Paramedic license.3.) All applicants must be a good standing EMT in Illini EMS at the time of the application.4.) Current seniors will not be considered unless you will be attending the University of Illinois at Urbana-Champaign for a full 5th year. 5.) All applicants must have had their EMT license for a year and have passed IEMS Critical Skills. Exceptions may be made in rare circumstances at the discretion of the IEMS Operations Department.6.) All applicants must be knowledgeable of all IEMS Standard Operating Guidelines and Region 6 Protocols, which can be found under the Documents tab of the Illini EMS website.ResponsibilitiesWeekly Supervisors ensure adequate staffing and quality patient care at all events that fall within their assigned supervisor week(s). Additionally, Weekly Supervisors assure transportation of necessary equipment to and from venues (working along with the Operations Equipment Officer and the Assistant Director of Operations).TrainingAfter a thorough review conducted by the Operations Department, accepted applicants are considered Supervisor Candidates. Supervisors Candidates must complete a specific training process in order to be recognized as an official IEMS Supervisor.Weekly Supervisor Candidates will undergo a 2-week training process. Week 1 will consist of shadowing all events that fall within a current Weekly Supervisor’s assigned supervisor week. Week 2 will give the Weekly Supervisor Candidate the opportunity to act as an independent Weekly Supervisor under the observation of a current Weekly Supervisor. Before the candidate can be approved, they must complete NIMS 200 and 800.*After this training process is complete, a final decision will be made in regards to your status as a Supervisor. An individual may be released to function as an official Supervisor, may be required to complete more training, or may be dismissed as a Supervisor Candidate and must wait until the next application cycle to reapply.DeadlineThis application is due no later than January 20th, 2017 at 6:00pm in the Assistant Director of Operations’ mailbox located in the IEMS office or emailed to rachfor2@illinois.edu. No late applications will be accepted. If chosen, you will receive further information regarding Supervisor training. If accepted into the training program, applicants who apply early will be trained first. If you have any questions about this application or Supervisor expectations, procedures, or general experiences please contact the IEMS Assistant Director of Operations, Connor Rachford(rachfor2@illinois.edu).Thank you for your interest and time,Connor RachfordAssistant Director of OperationsIllini Emergency Medical ServicesIllinois Fire Service InstituteSUPERVISOR APPLICATION2016-2017Name: ________________________________________________________________________(First)(M.I.)(Last)Local address: _________________________________________________________________Local phone number: ____________________________________________________________Email address: _________________________________________________________________Do you have a car on campus (circle): Yes NoCurrent Year in school (circle):Freshman Sophomore Junior Senior If Senior, will you be here for a 5th Year (circle): Yes NoExpected month and year of graduation: ________________________Number of semesters in IEMS: ___________Current level of EMT certification (circle): Basic Intermediate ParamedicMonth and year you received your EMT license: __________________List any additional certifications you may have: _____________________________________________________________________________________________________________________Total number of football games worked for IEMS: ________________Number of operational hours worked for IEMS during the Spring 2016 and current date: _________List the types of events you have worked for IEMS (e.g. Krannert, Gymnastics, Hockey):____________________________________________________________________________________________________________________________________________________________List any leadership roles you may have held in the past: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please list and describe two strengths and two weaknesses that you feel you possess:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please describe any EMS experience you have as a healthcare provider other than in IEMS:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please state why you would like the position you are applying for:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Describe the types of emergency medical situations you have had experience with (experiences during clinical/ride-time are accepted):__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________This application is due no later than January 20th, 2017 at 6:00pm in the Assistant Director of Operations’ mailbox located in the IEMS office or emailed to rachfor2@illinois.edu. No late applications will be accepted. ................
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