Ride Along Request Form

Ride Along Request Form

Background checks will be conducted on all requestors who are not a WA state licensed EMS provider or currently enrolled in an approved EMT/Medic program. Riders must be at least 18 years of age.
Today's Date
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Birth Date*

MonthDayYear
Reason for requesting a Ride Along":*

EMT/Medic school clinical hours requirementInterest in the professionApplying for employment with South County FireGeneral Interest
If for clinical/experience hours - name of school/program attending
Are you a WA State or NREMT licensed EMT or Paramedic?*
Do you have a friend or relative who works at SCF? - If so - Name
List 3 dates that you are available for your Ride. Hours are usually 9:00AM - 6:00 PM*
Should be Empty: