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 as soon as possible.

*Note:
-ANY INCOMPLETE/IMPROPERLY FILLED OUT SECTION OF YOUR APPLICATION WILL RESULT IN THE DELAY IN THE PROCESS OF YOUR APPLICATION.
-ALL APPLICANTS ARE SUBJECT TO A THOROUGH BACKGROUND CHECK BEFORE BEING RECRUITED AS A MEMBER, ANY OMITTED/INCORRECT INFORMATION MAY LEAD TO THE DISQUALIFICATION 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 18 and older may apply to be an EMT if they CURRENTLY have a valid NYS DOH Emergency Medical Technician - Basic certification.

ATTENDANT: Applicants 18 and older may apply to be an Attendant. Attendants assist the EMTs out on the ambulance as well as perform a variety of other tasks.

YOUTH CORP: Applicants ages 15 -17 may apply to be a Youth Corp. Youth Corp 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.
PLEASE CAREFULLY READ THE DESCRIPTION ABOVE AND CHOOSE THE POSITION BELOW ACCORDINGLY:
Position you are applying for *
DOUBLE CHECK THE ABOVE POSITION YOU ARE APPLYING FOR -
If you are 18 and over and do not currently possess a valid NYS EMT-B certification, you must apply as ATTENDANT.
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