EMS Education Course Enrollment


Thank you for taking an interest in one of our EMS Programs. If you would like to know more information about the courses that we offer, please fill out the form below and an EMS Education Representative will contact you.

If you would like to apply for one of our courses, please complete the enrollment form below.

 

Please allow 24 - 36 hours after submittal for a response from our EMS Education Department.



EMS Education Enrollment Form:
First Name*:
Last Name*:
Phone*:
E-Mail*:
Address*:
City*:
State*:
Zip*:
Are you 18 years of age or older?* Yes      No
Do you have a high school diploma or GED?* Yes      No
Are you currently a firefighter or MFR?* Yes      No
If yes, what department?
Have you ever had a felony conviction?* Yes      No
Which course would you like to enroll in?
  Please specify which program, i.e. Paramedic or EMT-B or PHTLS or AHA CPR.
 
Any item marked with a * is required..