Education at STAT EMS

EMS Course Enrollment Form

Thank You for taking an interest in one of our EMS Programs. Please allow 24 - 36 hours after submittal for a respons from our EMS Education Department.

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* Indicates Required Field

First Name*
Last Name*
Phone*
E-mail*
Address*
City*
State*
Zip*
Are you 18 years of age or older? *	Yes No
Do you have a high school diploma or GED?*	Yes No
Are you currently a firefighter or MFR?*	Yes No
If Yes, what department?
Have you ever had a felony conviction?*	Yes No
Enter the name of the course you would like to enroll in:*

For further questions about STAT EMS, please Contact Us.