IPSEMS | Ambulance Services In Canada, Industrial Health Safety, and Paramedic Canada

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Required: ( * )

Personal Information

* First Name:

* Last Name:

* Email:

* Address:

* City:

* Province:

* Country:

* Postal Code/Zip:

* Home Phone:

* Mobile Phone:

How did you
hear about us:

Please specify:

Medical Training and Qualifications

* Registration Number:

* Medical Designation:

* Province Registration:

Registered with ACP? Yes No

* Provide ACP number:

Do you have a H2S Alive ticket? Yes No

* Provide H2S Alive number:

* H2S expiry date:

Do you have a valid PST Ticket Number? Yes No

* Provide PST ticket number:

* PST expiry date:

Do you have a valid Driver's License? Yes No

* Provide driver's license number:

* Select class:

If 'Other' please specify:

* Expiry date:

* Availability:

* Available Starting Date:

* Are you comfortable being in remote areas for weeks at a time?

* Do you have transportation?:

Your résumé

You must provide a copy of your résumé for your application to be accepted.

Choose your format: You can send your file as an attachment and/or paste the contents as simple/plain text.

Upload as attachment:

Name your file using your first and last name.
Accepted file formats: Microsoft Word, PDF.
File size limit: 3 MB

Select file:

Upload as simple text:

Copy and paste your cover letter, résumé and references in the fields provided.
Please note that you must use plain text.

Tip: You may wish to paste text from a third party application such as notepad (Windows users) or TextEdit (Mac users).

Cover Letter:

Résumé:

References:

Upon submitting form please allow a few seconds for your file to upload. Do not reload the page or you will have to fill entire form out again.

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