MTCC and EMS Pre-Course Form
Please complete this form for any EMS class. A MTCC registration form is also required.
Course Title
*
Course Pre-Fix
*
EMS 3200
EMS 3048 (ACLS/ACLSEP)
EMS 3046 (PALS)
EMS 3041 (ITLS)
EMS 4402 (Paramedic CE/EMS In-service)
Location of Class
*
McDowell EMS Headquarters
MTCC
McDowell Communications
Other
Does this class lead to an federal, state, or industry recognized credential?
Yes, AHA
Yes, ITLS
Yes, NC OEMS (refresher Courses)
No
Begin Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Begin Time
*
Hour Minutes
AM
PM
AM/PM Option
End Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
End Time
*
Hour Minutes
AM
PM
AM/PM Option
Number of Hours
*
Instructor(s) and Number of hours taught
*
Submit
Should be Empty: