Section 1-780 - Class Grade Entry Form

CMH EMS Education Manual

To be completed by Instructor
Class name:
Completion date:		Healthstreams updated
Completion time:		Kronos updated
Lead instructor:	Name: Hours:	NAEMT updated and certs issued
Instructor #2:	Name: Hours:	OzarksEMS certs issued
Instructor #3:	Name: Hours:	NREMT updated
Instructor #4:	Name: Hours:	OzarksEMS credentials updated
Lead instructor signature:		Platinum updated
When completed, send this form to theron.becker@citizensmemorial.com.

Please complete the following form with students listed "last name, first name" in alphabetical order.