EMT and Paramedic Course Registration

Please complete and submit this online form to register for our EMT and Paramedic Course offerings. You can also print and mail in a hard copy registration using this Registration Form.

For additional information please visit our Web site. Or call 718 990-8436

All form fields with * are required.

* First Name:

* Last Name:

Address:

City:

State:

Zip:

* Phone Number:

()-

* E-mail:

Check off the course for which you are registering:

Please select one:

EMT Original
EMT Refresher
Paramedic Original
Paramedic Refresher

EMT Original

EMT Refresher/Challenge

Paramedic Refreshers/Challenge DAY Courses

Paramedic Refreshers/Challenge EVENING Courses