Catskill Camp Services, Inc.
P.O. Box 202
Cooperstown, NY 13326
T: (607) 433-0000

Providing EMS to baseball camps in Cooperstown

Application for Employment

Personal Information
Name:
Address:
City:
State:
Zip:
Telephone:
Schedule Availability:
(Camp is open 24/7)
Date Available to Start:

Shirt Size:

Qualifications
(A)EMT #:
Level:
Date of certification at current level:
EMS agency affiliation:
Other medical training:

References
Current employer:
Contact individual:
Contact telephone:
May we contact your employer?: Yes No
Reference 1:
Reference 2: