EMS-Basic EMT Training Training

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Student information

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First Name:

M.I.:

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Are you Hispanic/Latino? Yes No Race (Select one or more): American Indian or Alaskan Native Asian Black or African American White Native Hawaiian or Other Pacific Islander Immunization Status: (Up to date): MMR Tetanus PPD Covid Influenza (Accepted students will be required to submit proof of immunization status prior to start of course) Education Education (highest completed): High school diploma, GED or HiSet Some college/no credential Credential < 2-year degree (< associate degree) Associate degree Bachelor's degree Master's degree or higher By Clicking the `Apply Now` button below I certify that all information on this application is accurate and complete.