Supervisor Application


University of Iowa EMS Supervisor Application

Name (*)

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Address (*)

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City, ST ZIP (*)

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Home Phone (*)

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Work Phone (*)

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Email Address (*)

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Emergency Contact Name (*)

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Address (*)

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City, ST ZIP (*)

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Home Phone (*)

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Work Phone

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Email Address

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Availability (*)







Invalid Input During which times are you generally available for meetings and to work on assignments?
Interests (*)










Invalid Input In what areas are you interested in working with UIEMS?
How many years have you been a member of UIEMS? (*)

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Are you an EMS Provider? (*)

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Graduation Year (*)

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Long Term Career Goals (*)

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Special Skills or Qualifications (*)

Invalid Input Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies, internships, trainings, and other.
Previous Volunteer Experience (*)

Invalid Input Summarize your previous work and volunteer experience.
Essay 1 (*)

Invalid Input Being a UI EMS Supervisor is time consuming. Supervisors are expected to reply promptly to emails, return phone calls, and perform their own duties in a timely manner, without being asked to do so. How do you feel you will handle these tasks and manage your time?
Essay 2 (*)

Invalid Input Why do you want to be a UI EMS supervisor?
Essay 3 (*)

Invalid Input Tell me about a time when you have coordinated the work of other people. How did it turn out, what did you learn from the experience?

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. Supervisors will be required to purchase a polo shirt for the organization and be required to wear it whenever representing UI EMS. Supervisors will be held accountable for their actions and expected to fulfill their job responsibilities on a weekly basis. (*)

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It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Thank you for completing this application form and for your interest in volunteering with us.


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