E5 Support Services, LLC
Employment Application

  1. We believe our most valuable assets are the dedication and credibility of our field providers and staff. Our promise to you is exceptional, professional, pre-hospital care. We achieve this by continuing to provide our staff with ongoing training opportunities and events to better improve their skills each day. We choose our staff and providers by their commitment to the community and their career, as well as their desire to learn and grow. Most importantly, their compassion each time they are called to serve.

  2. By joining our team, our EMS employees can take advantage of the following benefits:

    • Competitive pay
    • Dental and Medical Insurance with additional Aflac options
    • Free training programs provided by E5
    • and more

    If you are interested, please fill out our application below. We look forward to meeting you.


EVO   BLS Provider   ALS Provider   Trainer  

Amity Rescue   Hague Fire & EMS   Hermon Fire   Hoosick   Massena   Maynard Fire Department  
Nassau   Norfolk Ambulance   Potsdam   Schroon Lake   Wellsville   Wallkill Ambulance  

Sunday (Day)  
Monday (Day)  
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Sunday (Night)  
Monday (Night)  
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Friday (Night)  
Saturday (Night)  

Yes   No


Please list three professional references that we may contact,

Physical Record

Yes   No

Yes   No


I certify that the answers herein are true and complete to the best of my knowledge. I understand that false or misleading information given in my application and/or interview(s) is grounds for refusing to hire me, or for discharge should I be hired. I also authorize investigations of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

I understand and agree that I may be required to pass one or more of the following: Physical examination, drug screen, respiratory evaluation, credit check and criminal record check, as a condition of hiring or continued employment.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written documentation or by conduct unless an authorized executive of this organization specifically acknowledges such change, in writing.

In the event of employment, I understand, also that I am required to abide by all rules and regulations of the employer.

Complete CAPTCHA requirements or your form data may be lost.

On the next step of the application you will be asked to provide supporting documents.

Prepare the following documents:

  • Resume
  • Cover Letter - Please address the following in your letter: Why you are interested in E5 Support Services, and what defines you as a professional.
  • Copy of valid driver's license
  • Copy of relevant certifications (NYS, AHA, and any others you feel are appropriate.)

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