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Health & Human Services

Emergency Medical Services

 

CCEMTP Program Application

 

*Required Field

Personal Information

*First Name:

Middle Name:
*Last Name:
*Email Address:
*Home Phone Number:
Cell Phone Number:
*Address:
*City:
*State:
*Zip:
*High School Name:
*High School Graduation   Year:
Registration Type: Initial Renewal

Program Prerequisites

Are you currently PALS, PEPP or ENPC certified?
   


Verify

 

Please click the submit button only once. It may take a few minutes for a confirmation message to appear.