Little Neck - Douglaston Community Ambulance Corps. - APPLICATION FOR MEMBERSHIP
Please use this form to apply to the Little Neck-Douglaston Community Ambulance Corps. A Personnel member will contact you within 3 business days. Should you not receive a response within 3 business days, please call (718) 423-2333.

*Note:
- ANY INCOMPLETE SECTION OF YOUR APPLICATION WILL RESULT IN THE DELAY OF THE PROCESS OF YOUR APPLICATION. PLEASE FILL OUT ALL APPLICABLE SECTIONS AS ACCURATELY AS POSSIBLE.

Email address *
Personal Information
Full Name *
First, Middle, Last Name. Ex: John Smith Doe
Your answer
Full Home Address *
In this format: "42-18 Marathon Parkway Little Neck, NY 11363"
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Gender *
Cell Phone Number *
In this format: 718-423-2333
Your answer
Secondary Phone Number
In this format: 718-423-2333
Your answer
Positions
Emergency Medical Technician - Basic (EMT-B): Applicants over the age of 18 may apply to be an EMT if they have a valid, current NYSDOH Emergency Medical Technician - Basic certification.

Attendant: Applicants over the age of 18 may apply to be an Attendant. Attendants assist the EMT-Bs out on the ambulance as well as perform a variety of other tasks.

Dispatcher: Applicants over the age of 18 may apply to be a Dispatcher. Dispatchers monitor and record telephone calls, answer radio calls, and direct ambulances to required locations. These members are considered the key to the entire ambulance operation in that they speed up service and enhance reliability, particularly when simultaneous emergencies occur. A dispatcher plays an important role throughout the emergency, as they relay patient information from the ambulance crew to the medical facility.

Youth Corp: Applicants ages of 15 -17 may apply to the Youth Corps program. The Youth Corps affords young adults with the opportunity to learn, grow, and mature outside the high school classroom. It strives to instill a sense of civic responsibility, as well as an understanding of the medical field. Youth Corp will be permitted on the ambulance only to observe. Youth Corp are only permitted to volunteer between 0700 hrs to 2200 hrs. Application to this program will require parental consent.

Position you are applying for *
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