Get Resa V -- Public Service Training Student Information Form (emt) - Images Pcmac

This guide provides clear instructions on completing the RESA V public service training student information form for EMT training. Follow these steps to accurately fill out the form and ensure proper submission.

Follow the steps to complete the form online.

1. Click the ‘Get Form’ button to access the form and open it in your online editor.
2. Enter today’s date in the designated field to ensure accurate record-keeping.
3. Fill in the course title and clock hours for the course you are enrolling in.
4. Provide the name of your organization and the course location to clarify where the training will occur.
5. Write down your county of residence to establish your local affiliation.
6. Input your last name, first name, and middle name as they appear on your identification.
7. Fill out your birth date, ensuring to check the month, day, and year boxes correctly.
8. Provide your current address, city, state, and postal zip code to contact you easily.
9. Input your social security number; note that it is not mandatory but recommended for record purposes.
10. Enter your telephone number and email address for communication regarding the course.
11. Indicate if you belong to a licensed EMS agency or fire department, and provide the agency's name if applicable.
12. Specify how long you have been affiliated with the named agency.
13. Check the items you wish to purchase, including tuition, lab fee, textbooks, workbooks, and pocket masks, and provide the total fees.
14. Complete the instructor's verification section and ensure payment is recorded correctly.
15. Read and acknowledge the student and instructor commitment statement, and sign where indicated.
16. Upon completion, you can save changes, download the form, and print it for your records.

Take action now and fill out your RESA V student information form online to ensure your place in the EMT training program.