Staff

 

EMS Program Staff

Program Coordinator: Kris Siewert SiewertK@lanecc.edu

Clinical Coordinator: Darrek Mullins MullinsD@lanecc.edu

Administrative Program Support: Marleena Pearson PearsonM@lanecc.edu

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.

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 EMS@lanecc.edu

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