Online Application

Pre-Screening Employment Application:

Each question should be answered in a complete and accurate manner as no action can be taken otherwise.

Name:

Phone:

Address:

City:

State:

Zip Code:

Email Address:

Qualification Information:

You must be a citizen of the U.S. and/or have the legal right to be employed in the U.S.

If you been convicted of ANY of the following charges in the last five years then you are ineligible for employemnt with Transcare Medical:

More than one moving violation in the last 12 months, or 2 or more in the last three years
More than one accident in the last three years
Speeding 25MPH over the speed limit
DUI
Reckless Driving
Negligent Driving
Suspended License
Eluding an Officer
Vehicular Homicide or Manslaughter
Hit and Run
Felony with Vehicle
Filing False Report
Permitting Unlicensed Driver to Drive

If none of the above apply to you please continue with the application process:

Position Desired:

Certification #:

Location/Station Desired:

Employment Type:

Are you 23 yrs or older:

Have you ever been convicted of any crime excluding minor traffic violations and other than what was listed above?

If yes, please state the offense, location, date and disposition:

Convictions:

Do you have the physical ability to move and/or lift as required by the job for which you are applying?

If no, please describe limitations:

Limitations:

Date available to start:

770-870-7083