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The following employment application is required to be completed by all those seeking employment with Life Flight Network. In addition to the employment application, if you would like to also submit resumes to our Human Resources department you may do so by uploading the document within the form below or by e-mailing your resume to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Note: All fields with (*) are required.

Job Information:
Position(s) Applying For: *	Invalid Input
Position Location: *	Invalid Input
Desired Wage: *	Invalid Input
Position Type: *	Invalid Input
Available Start Date: *	Invalid Input
Previously applied / employed with Life Flight Network: *	Invalid Input

Personal Information:
Name: *	Invalid Input
Mailing Address: *	Invalid Input
City: *	Invalid Input
State: *	Invalid Input
Zip Code: *	Invalid Input
Phone: *	Invalid Input
Email: *	Invalid Input

Education:
Institution #1: *	Invalid Input
Institution #2:	Invalid Input
Institution #3:	Invalid Input
High School Diploma or equivalent:	Invalid Input
Additional Education:	Invalid Input
	NOTE: Please list Accomplishment/Major, Date earned or expected, and School attended.

License:
License #1:	Invalid Input
License #2:	Invalid Input
License #3:	Invalid Input
	NOTE: Please list Type of license/certif./other, Number, Expiration/renewal date.

Employment History:
Please list the names of your present and previous employers in chronological order. Account for all periods of time including any period of unemployment or self-employment. Failure to respond to each inquiry may disqualify you for consideration of employment.

Employer #1
Employer Name:	Invalid Input
Employer Contact:	Invalid Input
Employment Dates:	Invalid Input
Job Title:	Invalid Input
Job Duties:	Invalid Input
Reason for Leaving:	Invalid Input
Starting Wage:	Invalid Input
Final Wage	Invalid Input
May we contact this employer?	Invalid Input
If No, explain why not:	Invalid Input
Employer #2
Employer Name:	Invalid Input
Employer Contact:	Invalid Input
Employment Dates:	Invalid Input
Job Title:	Invalid Input
Job Duties:	Invalid Input
Reason for Leaving:	Invalid Input
Starting Wage:	Invalid Input
Final Wage	Invalid Input
May we contact this employer?	Invalid Input
If No, explain why not:	Invalid Input
Employer #3
Employer Name:	Invalid Input
Employer Contact:	Invalid Input
Employment Dates:	Invalid Input
Job Title:	Invalid Input
Job Duties:	Invalid Input
Reason for Leaving:	Invalid Input
Starting Wage:	Invalid Input
Final Wage	Invalid Input
May we contact this employer?	Invalid Input
If No, explain why not:	Invalid Input
Employer #4
Employer Name:	Invalid Input
Employer Contact:	Invalid Input
Employment Dates:	Invalid Input
Job Title:	Invalid Input
Job Duties:	Invalid Input
Reason for Leaving:	Invalid Input
Starting Wage:	Invalid Input
Final Wage	Invalid Input
May we contact this employer?	Invalid Input
If No, explain why not:	Invalid Input

Additional Information:
Have you ever been convicted of a crime? Invalid Input
If yes, please provide dates and circumstances: Invalid Input
NOTE: "Conviction" means you were found guilty by a judge, a jury, by pleading "no contest" or "nolo contendere", or by pleading guilty in court or by paying a fine without appearing in court. A conviction may have taken place even if you did not pay a fine or spend any time in jail or prison. A "crime" includes felonies and misdemeanors (including but not limited to DUI, theft, battery, fraud, etc). Traffic citations such as speeding or parking fines are not included as "crimes" for purposes of this request. Please note that driving under the influence of alcohol or other drugs ("DUI") are considered "crimes" for purposes of this request. Do not include convictions for which you were later pardoned or juvenile records that have been sealed by court order. A conviction will not automatically disqualify you from employment. Life Flight Network will consider factors such as date, seriousness, nature of the offense and positions for which you have applied. If you do NOT disclose a conviction which is later discovered, any offer of employment that is made may be rescinded or your employment, if hired, may be immediately terminated.

References:
Reference #1
Name:	Invalid Input
Employer	Invalid Input
Title:	Invalid Input
Contact Information:	Invalid Input
Work Relationship:	Invalid Input
Comments:	Invalid Input
May we contact this reference?	Invalid Input
Reference #2
Name:	Invalid Input
Employer	Invalid Input
Title:	Invalid Input
Contact Information:	Invalid Input
Work Relationship:	Invalid Input
Comments:	Invalid Input
May we contact this reference?	Invalid Input

Upload Your Resume (optional)
Allowed file types are .pdf and .doc. Maximum file size is 1 MB. Invalid file type or file size too large

How did you hear about the opening? *	Invalid Input
	Invalid Input

Please read the Life Flight Network employment terms, conditions and disclosures before submitting your application.

I have read the Life Flight Network employment terms, condition and disclosures and completed the employment form accurately and to the best of my knowledge: * Yes

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