Supraglottic Airway Endorsement Course Application Question Title * 1. What is your first and last name as they appear on your DOH Credential? Question Title * 2. What is your Washington State Department of Health EMS Credential number? Question Title * 3. Which Mason County EMS agency are you primarily affiliated with? NMRFA District 3 District 4 CMFE District 6 District 11 District 12 District 13 WMF District 17 HFE Olympic Ambulance MCSO Other (please specify) Question Title * 4. What is your email address? Question Title * 5. What is your phone number? Question Title * 6. Please check the boxes to acknowledge the following course completion requirements: I have access to a computer or tablet and sufficient internet access to complete an online module. I must complete both my online module and the in-person practical skill assessment during the course window to receive my SGA endorsement from the Department of Health. Question Title * 7. What are your goals for completing this training? Done