Employment

Interested in working for APTS?

Simply fill out the form below, and click submit. You will be contacted for further information as soon as possible.

You may also download our fillable PDF form, fill it out and email it to employment@aptsems.com.

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Address:
119 East Holly Street, P.O. Box 652
Hazleton, Pennsylvania 18201

Business Office:
 570-453-1445
 570-459-0626

 
8a-4p M-F
Closed S-S

AMERICAN PATIENT TRANSPORT SYSTEMS INC

Employment Application

 


APPLICANT INFORMATION

Last Name*

First Name*

Middle Initial

Date of Birth*

Street Address*

Apartment/Unit

City*

State*

Zip*

Phone*

Email Address*

Position applied For*

Desired Salary*

Are you a citizen of the United States?*

If no, are you authorized to work in the United States?

Have you ever applied or worked for APTS?*

If so, when?

Have you ever been convicted of a felony?*

If yes, explain.

Is there any reason that you could not adequately perform the essential duties of the job for which you applied?*

If yes, explain.

 




EDUCATION

High School*

Address*

From*

To*

Did you Graduate?*

Degree*



College*

Address*

From*

To*

Did you Graduate?*

Degree*



Other*

Address*

From*

To*

Did you Graduate?*

Degree*



REFERENCES

Please list three professional references.

Full Name*

Relationship*

Address*

Phone*


Full Name*

Relationship*

Address*

Phone*


Full Name*

Relationship*

Address*

Phone*



PREVIOUS EMPLOYMENT

 


EMPLOYER 1

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 

 


EMPLOYER 2

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 

 


EMPLOYER 3

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 

 


DISCLAIMER AND SIGNATURE

I CERTIFY that all information provided in the employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my immediate dismissal if discovered at later date.

I UNDERSTAND that the employer may request an investigative consumer report agency, as well as a check of my criminal record. I understand that should this application or a criminal record check reveal a conviction of a crime, further processing of this application or my employment, if hired, may be terminated.

I understand that I will be required to possess a current and valid driver's license if my job requires me to drive in the course of my work.

I AUTHORIZE the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations from any legal liability in making such statements.

I hereby waive any right or claims I have or may have against all current and/or former employers, and their agents, employees and representatives and damages that may directly or indirectly result from use, disclosure or release of any information by any person or party, whether such information is favorable or unfavorable to me. I further waive any claim against APTS and any outside agency utilized by APTS as a result of any information which is obtained in this investigation.

This application is submitted with the understanding that upon acceptance of a formal employment offer, I will be required to pass APTS's pre-placement testing, which will include a drug and alcohol screen and a physical. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to the work for which I am applying.

I UNDERSTAND that, if hired, and voluntarily terminate my employment within the probationary period, I will be financially responsible for the cost of the drug and alcohol screening and the physical.

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT, NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE AT THE OPTION OF THE COMPANY OR MYSELF.

Name (Signature)*

Date*

AMERICAN PATIENT TRANSPORT SYSTEMS INC

Employment Application

 


APPLICANT INFORMATION

Last Name*

First Name*

Middle Initial

Date of Birth*

Street Address*

Apartment/Unit

City*

State*

Zip*

Phone*

Position applied For*

Desired Salary*

Are you a citizen of the United States?*

Are you authorized to work in the US?

Have you ever applied or worked for APTS?*

If so, when?

Have you ever been convicted of a felony?*

If yes, explain.

Is there any reason that you could not adequately perform the essential duties of the job for which you applied?*

If yes, explain.




EDUCATION

High School*

Address*

From*

To*

Did you Graduate?*

Degree*



College*

Address*

From*

To*

Did you Graduate?*

Degree*



Other*

Address*

From*

To*

Did you Graduate?*

Degree*



REFERENCES

Please list three professional references.

Full Name*

Relationship*

Address*

Phone*


Full Name*

Relationship*

Address*

Phone*


Full Name*

Relationship*

Address*

Phone*



PREVIOUS EMPLOYMENT

 


EMPLOYER 1

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 


EMPLOYER 2

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 


EMPLOYER 3

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 


DISCLAIMER AND SIGNATURE

I CERTIFY that all information provided in the employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my immediate dismissal if discovered at later date.

I UNDERSTAND that the employer may request an investigative consumer report agency, as well as a check of my criminal record. I understand that should this application or a criminal record check reveal a conviction of a crime, further processing of this application or my employment, if hired, may be terminated.

I understand that I will be required to possess a current and valid driver's license if my job requires me to drive in the course of my work.

I AUTHORIZE the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations from any legal liability in making such statements.

I hereby waive any right or claims I have or may have against all current and/or former employers, and their agents, employees and representatives and damages that may directly or indirectly result from use, disclosure or release of any information by any person or party, whether such information is favorable or unfavorable to me. I further waive any claim against APTS and any outside agency utilized by APTS as a result of any information which is obtained in this investigation.

This application is submitted with the understanding that upon acceptance of a formal employment offer, I will be required to pass APTS's pre-placement testing, which will include a drug and alcohol screen and a physical. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to the work for which I am applying.

I UNDERSTAND that, if hired, and voluntarily terminate my employment within the probationary period, I will be financially responsible for the cost of the drug and alcohol screening and the physical.

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT, NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE AT THE OPTION OF THE COMPANY OR MYSELF.

Name (Signature)*

Date*

AMERICAN PATIENT TRANSPORT SYSTEMS INC

Employment Application

 


APPLICANT INFORMATION

Last Name*

First Name*

Middle Initial

Date of Birth*

Street Address*

Apartment/Unit

City*

State*

Zip*

Phone*

Position applied For*

Desired Salary*

Are you a citizen of the United States?*

Are you authorized to work in the US?

Have you ever applied or worked for APTS?*

If so, when?

Have you ever been convicted of a felony?*

If yes, explain.

Is there any reason that you could not adequately perform the essential duties of the job for which you applied?*

If yes, explain.




EDUCATION

High School*

Address*

From*

To*

Did you Graduate?*

Degree*



College*

Address*

From*

To*

Did you Graduate?*

Degree*



Other*

Address*

From*

To*

Did you Graduate?*

Degree*



REFERENCES

Please list three professional references.

Full Name*

Relationship*

Address*

Phone*


Full Name*

Relationship*

Address*

Phone*


Full Name*

Relationship*

Address*

Phone*



PREVIOUS EMPLOYMENT

 


EMPLOYER 1

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 


EMPLOYER 2

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 


EMPLOYER 3

If none, enter N/A in every box.

Company Name*

Phone*

Company Address*

Supervisor*

Job Title*

Starting Salary $*

Ending Salary $*

Responsibilties*

From*

To*

Reason for Leaving?*

May we contact your previous supervisor for a reference?*

 


DISCLAIMER AND SIGNATURE

I CERTIFY that all information provided in the employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my immediate dismissal if discovered at later date.

I UNDERSTAND that the employer may request an investigative consumer report agency, as well as a check of my criminal record. I understand that should this application or a criminal record check reveal a conviction of a crime, further processing of this application or my employment, if hired, may be terminated.

I understand that I will be required to possess a current and valid driver's license if my job requires me to drive in the course of my work.

I AUTHORIZE the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations from any legal liability in making such statements.

I hereby waive any right or claims I have or may have against all current and/or former employers, and their agents, employees and representatives and damages that may directly or indirectly result from use, disclosure or release of any information by any person or party, whether such information is favorable or unfavorable to me. I further waive any claim against APTS and any outside agency utilized by APTS as a result of any information which is obtained in this investigation.

This application is submitted with the understanding that upon acceptance of a formal employment offer, I will be required to pass APTS's pre-placement testing, which will include a drug and alcohol screen and a physical. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to the work for which I am applying.

I UNDERSTAND that, if hired, and voluntarily terminate my employment within the probationary period, I will be financially responsible for the cost of the drug and alcohol screening and the physical.

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT, NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE AT THE OPTION OF THE COMPANY OR MYSELF.

Name (Signature)*

Date*