APPLICATION/ONBOARDING

Honoring Our Profession, and the way our Heroes served.

First name

Middle name

Last name

Email

Mobile Phone (text accepted)

Address

City

State

Zip Code

COUNTY of Residence

Position Desired

Preferred District

Relative Experience

WI EMS License Number

Licensure level

BACKGROUND CHECK AUTHORIZATION

I authorize verification of criminal history and licensure.

EMS Practitioner

I am or have been a Wisconsin EMS provider. I am a retired EMS provider, EMS physician, or a registered nurse who works ambulance shifts.

VOLUNTARY PARTICIPATION & ELIGIBILITY

I acknowledge that Participation is a voluntary at-will position and I am at least 18 years of age and legally competent

I AGREE TO ACCEPT TEXT MESSAGES from Text-em-all, which is our alert notification system. How we communicate LODD Funerals, important reminders or updates.

MEDIA & PUBLIC REPRESENTATION POLICY

I agree my image/likeness may be used for training and media and I

will not represent the organization publicly without authorization from the State Commander

ASSUMPTIONS OF RISKSI agree to release WIEMSHGA, its officers, and leadership from all liability and waive any claims for injury, loss, or damage. I also agree to hold the organization harmless and indemnify it. This release includes claims arising from negligence, as well as actions or omissions by representatives of the organization. I assume all risks associated with my participation and hold the Association, its officers, and leadership harmless from any claims arising from my involvement.

CODE OF CONDUCT

I agree to uphold professional standards follow all polices and represent the organization with integrity

UNIFORM & EQUIPMENT RESPONSIBILITY

I accept responsibility for the issued equipment and understand that I must fund my uniform order through the approved supplier. Logos are copyrighted and may not be used without the express consent of the commander/board.

HEALTH AND MEDICAL

I understand that participation may involve risks, including, but not limited to Physical exertion and fatigue, Environmental exposure (weather, terrain, travel) Standing for extended periods and ceremonial duties, Emotional stress (funerals, LODD events) and Risk of injury, illness, property damage, or death

I voluntarily assume all risks, known and unknown. I authorize WIEMSHG to obtain emergency care for me if necessary.

FINANCIAL POLICY

I agree that I will not incur expenses or obligations on behalf of the Honor Guard Association.

MEMBER RESPONSIBILITIES

I agree to follow all policies, procedures, and directives. I will maintain both physical and mental readiness and exercise reasonable care for safety. I will report any unsafe conditions or injuries immediately.

I agree to follow all policies, procedures, and commands. Maintain physical and mental readiness. Exercise reasonable care for safety. Report unsafe conditions or injuries immediately.

Signature

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Link to CV/LinkedIn

Your current Service Director's Letter of Recommendation