Tri-C's Emergency Medical Services Program Interest Form

* fields are required

First Name: *

Last Name: *

Email: *

Phone Number: *

S-Number: *

How did you hear about us: *

Other: *

I plan to enter my EMT program in: *

Program of Interest (Check all that apply): *

EMT Basic Certificate (Day)
EMT Basic Certificate (Evening)
EMT Paramedic Certificate (Day)
EMT Paramedic Certificate (Evening)
EMT Associate of Applied Science Degree (Day)
EMT Associate of Applied Science Degree (Evening)
Fire-EMS Associate of Applied Science Degree (Day)
Fire-EMS Associate of Applied Science Degree (Evening)

Do you have a specific question?:

By completing this form you are requesting information about the EMT and Paramedic Programs. Students will need to complete the EMT Application Packet in order to apply to the EMT or Paramedic programs.

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