EMS Certifications

EMT · AEMT · Paramedic Interest Form

Tell us about yourself and the track you're pursuing. A program coordinator will follow up with cohort dates, pricing, and enrollment steps.

Student Interest Form

Required fields are marked with *.

Track of Interest *

Personal

First Name *

Last Name *

Email *

Phone *

Date of Birth *

City *

State *

ZIP *

Background

Highest Education *

Employment Status *

Current Certification Level *

Eligibility (check all that apply)

I am at least 18 years old (or will be at course start)I have a valid driver's license or state IDI can lift and carry at least 100 lbsI can pass a background check and drug screenI hold (or am willing to obtain) a current BLS/CPR card

Scheduling

Schedule Preference (check all that apply)

Weekday DaysWeekday EveningsWeekendsHybrid (in-person + online)Accelerated / Fast Track

Preferred Start Date

Funding (check all that apply)

Self-payEmployer-sponsoredScholarship interestGI Bill / VA benefitsPayment planWorkforce / agency program

Why are you pursuing this certification? *

Questions or comments

How did you hear about us? *

Optional Documents

Transcript / DiplomaClick to upload transcript / diploma

Current Cert CardClick to upload current cert card

PDF, JPG, PNG, DOC, or DOCX. Max 8 MB per file.

I'd like to receive cohort announcements, scholarship opportunities, and program updates.

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