top of page

814-695-1421

HOME
SERVICES
MEMBERSHIP
EMPLOYMENT
TRAINING
ABOUT
CONTACT
More

Use tab to navigate through the menu items.

Blood Pressure

Thank you for your interest in joining our Training Center!

TRAINING

Say Hello

The statements made herein are subject to verification to determine your qualifications for student consideration.

Advanced EMT Course Application

First Name

Last Name

Address

Phone

Email

Are you currently certified as a PA EMT-Basic?

Yes

No

How long have you been an EMT-Basic?

Less than a year

1-3 years

4-10 years

Greater than 10 years

Do you currently hold a CPR certification?

Yes

No

If so, please list your expiration date

Do you currently hold an EVOC certification?

Yes

No

Emergency Medical Care Information

EMT-Basic Certification #

Expiration Date:

Emergency Medical Agencies Affiliated With (Present and Past)

Attach additional sheets if needed.

Upload File

Upload supported file (Max 15MB)

Please explain why you want to become an Advanced EMT

EMS References: Please list Name, Agency, Job Title and Contact Information

Has your certification ever been on probation or revoked? If yes, please explain why.

Application Date

Thanks for submitting! We will be intouch with you shortly!

801 Scotch Valley Road
(814)695-1421
info@halasems.org

© 2022 Hollidaysburg American Legion Ambulance Service

Notice of Privacy Practices

bottom of page