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DAYTIME EMT-B CORE REFRESHER

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					           DAYTIME EMT-B CORE REFRESHER
DATE:         MAY 25, 26 and 27, 2011
TIME:         9:00AM – 6:00PM

Course Site:         Morris County Public Safety Training Academy
                     500 West Hanover Avenue, Parsippany, NJ

Registration Information: 908-522-2323 (Press 3)

FEES:

      Volunteer Services – NJ Training Fund Eligible         Non-eligible Applicants

        Free - Must Provide Certificate of Eligibility                $200

This course is designed to represent the core refresher knowledge and skills required
for the EMT-B to recertify in NJ. The course offers the complete 24 continuing
education units towards the EMT-B core curriculum. EMT’s expired less than two (2)
years can use this course to recertify as an EMT, however, upon successful completion,
they must take the NJ State EMT-B examination.
This program is conducted for three (3) days and includes classroom instruction, and
practical skills. In order to successfully complete this course, the student must attend all
sessions, plus obtain a score of at least 70% on the final evaluation, and successfully
pass the skills station.

Make checks payable to – Atlantic Ambulance, and remit to:
            Atlantic Ambulance
            EMS Training Center
            PO Box 220
            Summit, NJ 07902
           Fax: 908-522-5394

WE WILL NOT RESERVE A SPOT IN THE CLASS
UNLESS YOUR APPLICATION IS COMPLETE.
          DAYTIME EMT – B CORE REFRESHER
Dates – May 25, 26 and 27, 2010

Please Print Clearly

NAME:__________________________________ DAY PHONE: _________________

ADDRESS:____________________________________________________________
____

CITY/ZIP:________________________________OEMS#_______________________
____

AFFILIATION:______________________________DATE OF BIRTH: ___/____/_____

CPR EXPIRATION: _____/_____/_____ (Enclose Copy)

E-Mail Address:___________________________________________________



For office use only

___________Payment or COE

___________Insurance Form or insurance card

___________CPR Card

____________Parental Permission (if under 18 y.o.)

____________NJOEMS ID #

____________Background check received

____________Completed Confirmation sent




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posted:10/19/2011
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