Whenever the board of trustees of an emergency services district desires to levy a special tax to provide an ambulance service or support an existing ambulance service, it shall certify the question to the proper election officials, who shall submit that question at an election to the voters of the district. The result of the referendum shall be entered upon the records of the district. If a majority of the votes on the question are in favor of the question, the board of trustees may then levy a special tax at a rate not to exceed 0.40% of the value of all taxable property within the district as equalized or assessed by the Department of Revenue. The question shall be in substantially the following form:
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     Shall the ….
Emergency Services 
District levy a special tax at a rate             YES
not to exceed 0.40% of the value of all
taxable property within the district        ——————
as equalized or assessed by the
Department of Revenue for the purpose             NO
of providing or supporting an ambulance
service?
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     A tax levied under Section 11 may be used for ambulance services as well as a tax levied under this Section.