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* 1. Personal Information

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* 2. Date of Birth

Date

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* 3. I have a current driver's license which is required to register

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* 4. I have a high school diploma or a GED

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* 5. I have completed an EMT basic course and hold a current EMT card

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* 6. I hold a CPR card from the American Heart Association "Healthcare Provider Level"

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* 7. I have a minimum of 1000 hours of part-time or full-time experience as an EMT prior to the application deadline.

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* 8. Employment Information

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* 9. Have you attended another Paramedic Program

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