EMS Paramedic Program Admission Application

Program Type:

Your Name:

First NameLast Name

NSHE ID (Student ID Number):

Email:

example@mail.tmcc.edu

Phone Number:

Please enter a valid phone number.Format: 000-000-0000.

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are you a current TMCC student:

Do you live in Nevada?

Do you intend on seeking employment in Nevada upon completion of your program?

Will you be using VA Education Benefits for this program?

Education

Education Level:

Name of College:

Location (City/State):

Date Attended From:

Date Attended To:

Degree/Subject

Have you completed a Bridge Level in the EMS Program?

Which Bridge Level:

EMS 204

EMS 204 is a prerequisite to the Paramedic Program. You need to receive an 80% or higher.

Have you taken or are you currently enrolled in EMS 204?

Do you plan to take EMS 204 in the summer?

Have you taken BIOL 223 and BIOL 224 (or an equivalent approved by the department) and received an 80% or higher in those courses?

Have you declared an AAS, Prehospital Emergency Medicine Degree?

Current Level of NV Certification

Type:

State:

NREMT or State Certification Number:

Expiration Date:

Upload Copy of Your State EMT/AEMT Certification (or NREMT if only):

Upload Copy of Your State EMT/AEMT Certification (or NREMT if only) Status:

Employment

Do you currently work in the medical field?

Do you have at least 2 years of experience working in the emergency field?

Company/Agency Name:

Supervisor:

First NameLast Name

Telephone:

Please enter a valid phone number.Format: 000-000-0000.

Emergency Contact

Name:

First NameLast Name

Relationship:

Telephone:

Please enter a valid phone number.Format: 000-000-0000.

Attach Resume and Statement of Purpose

Candidates must submit with this application 1) your resume and 2) a one-page Statement of Purpose letter stating why you desire to become a Paramedic.

Upload Resume:

Upload Resume Status:

Upload Statement of Purpose:

Upload Statement of Purpose Status:

Unofficial Transcripts

Upload your unofficial transcripts from all coursework completed, including coursework you completed at TMCC. Note that in order to be processed, your official transcripts must be submitted directly to TMCC's Admissions and Records Office in a timely manner.

Upload Unofficial College Transcripts:

Upload Unofficial College Transcripts Status:

Certification and Acknowledgment

By pressing Submit, I hereby certify that I have personally read and completed the foregoing, and understand the application criteria and procedures for the Paramedic Program. I accept complete responsibility for requesting all required official documents.

Additionally, I understand that this degree/certificate leads to professional licensure in Nevada. Licensing requirements vary by state and territory, and relocating may impact my eligibility for licensure. If I do not reside in Nevada and/or do not plan to seek employment in Nevada, my application will be reviewed to determine eligibility for licensure in my state before acceptance into the program.

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