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Apply for EMT Student

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Summary
Title:EMT Student
ID:1020
Department:EMT Academy
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
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* Phone:
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EMT Student Application
APPLICANT INFORMATION
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REFERRAL SOURCE
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CERTIFICATES, LICENSES and/or MEMBERSHIPS

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EDUCATION
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EMPLOYMENT AND VOLUNTEERISM
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MILITARY SERVICE
REFERENCES

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PLEASE DESCRIBE WHY YOU WISH TO BECOME AN EMT
ELIGIBILITY FOR EMT CERTIFICATION PER THE COMMONWEALTH OF MASSACHUSETTS

This course has been developed for all individuals desiring to perform emergency medical care with an ambulance service. No prior experience or training is required of the course applicant. In order to be eligible for the state EMT certification examination the applicant must:

  • be 18 years of age
  • be able to lift and carry 125 pounds
  • be able to read, understand and communicate in English
  • be free from addiction to alcohol or any drug
  • be free from any physical or mental defect or disease which might impair his/her ability to provide emergency care within the scope of the EMTs training and responsibilities, or which might jeopardize the health of another member of the class

The student must also successfully complete the Basic EMT course including 100% attendance.


These requirements are from the OEMS website and can be found at:


http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/oems/emt/initial-training/oems-training-basic.html


EMT Academy’s Basic EMT program is designed to prepare our students for the psychomotor skills (practical) evaluation administered by the Massachusetts Office of Emergency Medical Services (OEMS), as well as the cognitive (written) examination administered by the National Registry of Emergency Medical Technicians (NREMT). Once a candidate has successfully completed our course and passed each of the aforementioned tests they can then apply to the Commonwealth of Massachusetts for their EMT certification by filling out an application and paying the required fee.


I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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