Advanced EMT Summer 2021 Request for Enrollment
This is the OFFICIAL request for AEMT Summer 2021 enrollment. Class will be at the Columbia campus Mondays through Thursday from 14:30-21:45. Filling this out does NOT guarantee you a spot in this course. To be fully eligible, please visit the admissions criteria at www.columbiastate.edu/academics/health-sciences/emt-paramedic/aemt-information. If you have any questions about this program, please email the program coordinator at gjohnson27@columbiastate.edu.

The summer 2020 AEMT offering will have a minimum enrollment number for the course to make. Students will be notified if the course does not reach enrollment numbers for the course to proceed.
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Last Name *
First Name *
A# (Your Assigned Columbia State ID) *
If you do not have one yet, you must apply to the college first (columbiastate.edu/admissions)
Email address *
YOUR email. The one you check on a regular basis
Phone Number *
The one you will answer. Not your parent's. Not your friend's. YOURS.
TN EMT License # *
Candidates for the AEMT program must be a currently licensed EMT-B in good standing OR have completed a EMT-B course elsewhere within 120 days of the start date of this course.
NREMT # *
If you graduated from an EMT program within the last 120 days, I only need your National Registry number
County you live in *
This is for statistics. Please tell me what county you live in.
Final Note
While this is not an academically competitive admissions program, admissions will be based on your motivation to fulfill all administrative requirements. Failure to meet deadlines at any point of this process may lead to withdrawal from the program. If you have any questions about this process, please email the EMT/ AEMT Coordinator at gjohnson27@columbiastate.edu.
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