EMPLOYMENT/VOLUNTEER APPLICATION
PA EMT/Medic/PHHP** CPR (Healthcare Provider)** ACLSMedic/PHHP** Driver’s License** EVOC** HazMat (Level) BTLS/PHTLS PALS Medic/PHHP** National Registry Other (specify): IS 100, 200, 700** Instructor certification(s): Criminal Record Check (SP4-164)** Child Abuse History Clearance Form (CY 113)** Additional Medic/PHHP Information Required at ... ................
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