NREMT Proctor Form

NREMT AEMT/ Paramedic Psychomotor Proctor Registration Form

Psychomotor Event to be held at: 10710 White Bluff Road, Savannah, GA 31406; on the property of White Bluff Presbyterian Church. For details, contact (912) 713-2250
Level of Certifcation
***Be advised, you must be operating in your current role for greater than 2 years***
Examination Date*
Name*

First NameLast Name
E-mail*
Phone Number*
Address*
The national registry exam is scheduled to begin at 0900hrs. All proctors are to be onsite by 0830hrs to assist with setup of all stations.

Minimum pay for the day will be $75.00, but will be based on the length of the day.

Compensation:

0 - 5 hrs, $75.00

5 - 6.5 hrs, $100.00

6.5 - 8 hrs, $125.00

8 hrs - 9 hrs, $150.00

9 hrs - 10 hrs, $175.00

Runner: $75.00 [16y/o and up] (does not need to be an EMT, will act as an Exam Coordinator Assistant)

Patient/ Assistant: [16y/o and up] (does not need to be an EMT)
Last 4 of SSN *
NREMT #
State EMT License #
Employer*
Should be Empty:

NREMT AEMT/ Paramedic Psychomotor Proctor Registration Form