EMS Program Staff
Interim Program Coordinator: Kris Siewert SiewertK@lanecc.edu
Clinical Coordinator: Darrek Mullins MullinsD@lanecc.edu
Administrative Program Support: Marleena Pearson PearsonM@lanecc.edu
Program Director and Interim Division Dean: Cory Miner MinerJC@lanecc.edu
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.
W-9 Form
Vendor ACH Form (Direct Deposit)
Volunteer Waiver of Liability Form
EMS Program Instruction Invoice
If you have a Gmail account, you will be able to attach the W-9 when you complete the EMS Program Instruction Invoice. If you do not have a Gmail account, you will need to attach it to an email to EMS@lanecc.edu