Must be a VA State EMT. Enter Certification # below:
EX: B010101010
Current Date
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Month
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Day
Year
Date
Date of Birth. Must be 19 years of age or Older.
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Month
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Day
Year
Date
Age
You do not meet the minimum age qualification of 19 with the birth date that you entered.
Please select one of the options below regarding your experience:
I have been cleared as an AIC in the ODEMSA region for 1 or more years.
I have been cleared as an AIC in the state of VA for 3 or more years.
Agency you were an AIC at:
Submit
Should be Empty: