EMS Program Staff

Program Coordinator: Kris Siewert

Clinical Coordinator: Darrek Mullins

Administrative Program Support: Marleena Pearson

Division Dean: Cory Miner

Independent Contractors

If you have been asked to work for Lane’s EMS Program as an Independent Contractor for exams or as instructional support, please print and fill out the W-9 Form below. Then complete the EMS Program Instruction Invoice form so that we can gather your contact information (mailing address for sending a check) and details on the service you provided.

If you have a Gmail account, you will be able to attach the W-9 when you complete the Google Form Invoice. If you do not have a Gmail account, you will need to attach it to an email to

W-9 Form

Vendor ACH Form (Direct Deposit)

Volunteer Waiver of Liability Form (Only for Patients and Runners)

Independent Contractors: Special Events

This is for anyone working to provide first aid/BLS to an event such as marathon, baseball game, football game, graduation, concert or any other even that is NOT part of a class instruction or evaluation.

EMS Services at Special Event Invoice

Independent Contractors: Corvallis Trainings

This is for anyone working on an EMT or AEMT/EMTI training in Corvallis coordinated by Jason Dennis.

EMS Corvallis Instruction or Evaluation Invoice

Independent Contractors: Eugene Trainings

This is for anyone working on an EMT, WEMT,  AEMT/EMTI, or Paramedic training in Eugene (program instruction or evaluation on exams, not first aid at events)

EMS Eugene Instruction or Evaluation Invoice