EMT 2021-2022
Please fill out all of the information.  Please be advised, even though you have applied, not all applicants will be accepted based on limited class size. EMT is a rigorous adult level training program, 10 hours of concurrent credit through SLCC is available to those who successfully complete this course. By industry requirement, you must be 18 by September 10, 2022 to take this class as a Senior.  Applications need to be completed by May 14, 2021.  You will receive your starter packet in the mail to the address you specify on this form if you have been accepted into the class. Contact Sadie Riel at sriel@graniteschools.org with questions. This course requires a TB test, fingerprinting, and participation at the hospital will require 2 step TB test, current immunizations with flu shot, and drug screen prior to clinical hours. This is the same requirement for any adult medical program.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Birthdate (ex: 07/20/2000) You must be 18 by Sept. 10, 2022. This is the Fall after you graduate. *
MM
/
DD
/
YYYY
Phone Number - Where you can receive text. *
Student Number *
Home School *
Cumulative GPA *
Email Address - Needs to be checked regularly! *
Home MAILING Address - If you have been accepted into the program, you will receive a packet in the mail by beginning of June 2021 to this address so you will have the summer to work on it. *
City *
State *
Zip Code *
Previous Medical Classes Taken *
Why would you like to be an EMT? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms