CMH EMS Education Application Form

Your name:

Your email:

Agency you belong to (not required, but helpful):

Your cell phone number (not required, but this is the secondary means of communication):

Your billing address:

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Which academy are you enrolling in?

• No AcademyEMDEMREMR LEEMTEMT InternshipAEMTParamedicCritical CareCommunity ParamedicOnboardingEducatorSupervisorManagerExecutive

Which class type are you enrolling in?

• No Class TypeACLSAHDRAMLSBLSCEUCompetencyCPSEMDEMT RefresherEVOSGEMSHazmatInstructorPALSParamedic RefresherPHTLSPTEPQualitySafetyTCCCTECCTIMS

Class name:

Start date/time:

Pay attention here and don't miss these last steps:

1. If you are applying for an Academy, download, sign, and return the criminal history consent form.
2. Check to see if this course has an application fee or tuition and how to pay.
3. After steps 1 and 2 above, click: