Department Questionnaire Department Name (required) Location (required) Contact Name (required) Contact Email (required) Contact Phone OfficeCell Department Information Staffing (check all that apply) CareerPart-TimeVolunteer Shift Type 12-Hour24-Hour Entry Level Requirements (check all that apply) Entry Level Position Career FF/EMTPart-Time FF/EMTVolunteer/EMT National Testing Required YesNo CPAT Required YesNo Department Reimbursement Requirements Required Shifts per Month 1234567 Amount of reimbursement every 6 months $200$300$400$500$600$700 Maximum Reimbursement Payout$2000$2500$3000 List other requirements for reimbursement
