Medical Specialist

You must complete and submit all items in this section for your application to be considered.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Employer *

Current Position With Employer *

Email Address *

Cell Phone Number *

Are you a US Citizen? *

Please upload your EMT/P, RN, RN-P, PA license *

Please upload your ICS 100 *

Please upload your ICS 200 *

Please upload your ICS 700 *

Please upload your ICS 800 *

Please upload your Resume *

Please upload your recommendation letter from an Agency Chief/Point of Contact *

Please upload your essay *

Please upload a copy of your driver's license *

Please check those certifications that you have and upload copies below

Submit recommended files here