Apply Online Step 1 of 714%Personal InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Job InformationPosition(s) Applying for:*Position Location*Desired Wage*Position TypePart-timeFull-timeAvailable Start Date* MM slash DD slash YYYY Have you previously applied with Life Flight Network?* Yes NoHave you previously been employed with Life Flight Network?* Yes NoStart Date Month Day YearEnd Date Month Day Year Education InformationEducation HistoryInstitutionGraduated (Y/N) High School Diploma or equivalent Yes NoAdditional Education:License InformationList Licenses Aviation Hours (if applicable)Total hours as pilot in commandTotal rotor wing hoursTotal rotor wing turbine hoursTotal simulated/actual instrument hoursTotal unaided night time hours Employment HistoryPlease 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 #1Employer #1 Name*Employer Contact*Employment Dates*Job Title*Job Duties*Reason for Leaving*May we contact this employer?*YesNoIf no, please explain why notEmployer #2Employer #2 Name*Employer Contact*Employment Dates*Job Title*Job Duties*Reason for Leaving*May we contact this employer?*YesNoIf no, please explain why notEmployer #3Employer #3 Name*Employer Contact*Employment Dates*Job Title*Job Duties*Reason for Leaving*May we contact this employer?*YesNoIf no, please explain why not ReferencesProvide three references, preferably current/previous managers or supervisors if possible. By providing the below references you agree to allow Life Flight Network to perform reference checks during the recruitment process.Reference #1Reference #1 Name*Company Name*Relationship (i.e. Manager, Co-Worker)*Phone Number*Email Reference #2Reference #2 Name*Company Name*Relationship (i.e. Manager, Co-Worker)*Phone Number*Email Reference #3Reference #3 Name*Company Name*Relationship (i.e. Manager, Co-Worker)*Phone Number*Email Additional InformationHave you ever had your Medic, RN, Pilot, Mechanic or other professional license relevant to the position you are applying for suspended or revoked?* Ye No N/AA "yes" answer will not necessarily prevent an applicant from being hired.Cover Letter, Resume, Certifications, etc.Please upload a resume, cover letter, certifications, references, etc (optional). Drop files here or Select filesMax. file size: 128 MB, Max. files: 10. How did you hear about this opening?* Life Flight Network Website Indeed.com Craigslist.org Glass Door Flight Web Life Flight Network Employee AAMS Nurse.com NANN JS Firm Facebook OtherWhere did you hear about this opening?*Employee Name* First Last Employment Terms, Conditions and DisclosuresPlease read the following:I understand that, if employed, I may be required to work at locations other than my current assignment as the needs of the organization require, and that my employment is subject to complying with the rules, regulations, and conditions established by management.I understand that a physical assessment or examination, including drug screening and evidence of required immunity may be required after an offer of employment and I give my consent for this requirement. I further understand that if I am employed I will be subject to drug and alcohol testing if there is a reasonable suspicion that I am using drugs or alcohol or that I am under the influence of drugs or alcohol. I hereby consent to such testing.I understand and agree that if I am offered and accept the position, unless otherwise agreed, all employment with Life Flight Network, LLC is "at will" meaning that both the employee and the employer reserve the right to terminate the employment relationship at any time, for any reason, with or without prior notice. I also agree to conform to all existing and future policies, rules and regulations of Life Flight Network and understand that Life Flight Network, LLC and its operating units reserve the right to change wages, hours and working conditions as deemed necessary.As part of the evaluation process, a consumer report, including a criminal history background check and reference check, may be obtained from one or more consumer reporting agencies. I give Life Flight Network, LLC permission to obtain information regarding my previous work experience and to investigate all information provided during the application process. I release from liability or responsibility Life Flight Network, LLC and all persons, companies, or corporations providing information to Life Flight Network, LLC about me.By submitting this application, I hereby acknowledge that I have read and understand the above statements. I certify that all answers to questions in this application and all additional information I may have submitted are true and complete to the best of my knowledge. I understand that giving false information, misrepresenting facts, and material omissions may be grounds for denial of employment or discharge if hired.If hired by Life Flight Network, I understand I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States.This application will be considered active for employment for a maximum of 60 days. If you wish to be considered for employment after that time you must reapply.Please read the Life Flight Network employment terms, conditions and disclosures above 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.NameThis field is for validation purposes and should be left unchanged.