2. 
4. First Name*
5. Last Name*
7. City
8. State
10. Phone Number
11. Email Address
13. Do you have an NREMT certification?
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15. Do you have EMS experience? Please tell us about it.
17. Do you have any specific questions about working for East Baton Rouge Parish EMS that we can answer for you?
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18. 1. Receive an email copy of this form.
19. Email address

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20. Submit

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