Hudson EMS
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ALL FIELDS ARE MANDATORY
YOU MUST PAY IN FULL WITHIN 2 BUSINESS DAYS. PLEASE CALL 216-523-7040, PRESS "0" TO PROCESS PAYMENT. ALL FORMS OF CREDIT OR DEBIT CARDS ARE ACCEPTED.
1.
First Name:
*
2.
Last Name:
*
3.
Home Street Address
*
4.
City
*
5.
State
*
6.
Zip Code
*
7.
Phone
*
8.
E-mail Address:
*
THIS IS THE PRIMARY MEANS OF REGISTRATION AND COMMUNICATION.
9.
Please enter the name of your Fire Department, EMS Service or place of employment/affiliation.
*
10.
Please select the course you wish to enroll in.
*
--Please Select--
30hr EMT Basic Refresher
48hr Paramedic Refresher
ACLS
AMLS
GEMS
ITLS
PALS or PEPP
11.
Please select your level of certification.
*
--Please Select--
EMT-Basic
EMT-Intermediate
EMT-Paramedic
RN