Paramedic Internship

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  Photo: Paul Chinn, The Chronicle

Photo: Paul Chinn, The Chronicle

Feature 1

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Feature 2

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  Photo: David Yee, Berkeleyside

Photo: David Yee, Berkeleyside


  Photo: BFD

Photo: BFD

Feature 3

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Your Demographics
Name *
Name
Address *
Address
Emergency Contact Info.
A personal emergency contact (family, friend, etc)
Name *
Name
Cell Phone *
Cell Phone
Paramedic Program Information
Program Mailing Address
Program Mailing Address
Directors Name *
Directors Name
Clinical Coordinators Name
Clinical Coordinators Name
Clinical Coordinators Phone #
Clinical Coordinators Phone #
Emergency Contact Name *
Emergency Contact Name
Program Emergency Contact Information (the person to contact at the school in the event of an injury or other emergency)
Emergency Contact Phone # *
Emergency Contact Phone #
Program Emergency Contact Information (the person to contact at the school in the event of an injury or other emergency)
Prior Internship Experience
If you started an internship but did not complete it, please provide the information below. Otherwise, skip this section.
Name of Preceptor
Name of Preceptor
Preceptor's Phone #
Preceptor's Phone #
Internship Start Date?
Internship Start Date?
Internship End Date?
Internship End Date?
Additional Information
Final Agreements & Disclaimer
I will be thoroughly knowledgeable of Alameda County EMS protocols prior to the commencement of my internship. I will adhere to the uniform requirements set by the Berkeley Fire Department; dark BDU style EMS pants, school uniform shirt, dark work boots and an ID badge. I will come to my internship each day with a clean uniform and be well groomed. I certify that my answers throughout this application are true and complete to the best of my knowledge. If this application leads to an internship, I understand that false or misleading information in my application or interview may result in my release.
I agree to the above *
Notice to Applicants
Applications will be processed upon receipt. Completed applications will be placed in the Department’s “Available” intern file. Selection for placement will be based upon Preceptor and space availability. The Berkeley Fire Department paramedic internship coordinator will contact you to schedule an interview and/or ride along. Thank you for your cooperation.