All students must have a PSID number. If you are not currently affiliated with a fire department or EMS agency, you can apply online with the Indiana Department of Homeland Security (IDHS) for a PSID number. Click here for the IDHS website.

Please state your current or last employer information

1. The facts as stated on this application are true and correct.  I understand that, if accepted in the education program, a false statement on this application may result in my immediate dismissal.
2. I authorize such background and personal reports as deemed necessary to verify that the information I have supplied is true and accurate and to determine my fitness for this class.  A copy of this authorization is as good as the original.
3. I agree to conform to the rules and regulations of the training institution, Harrison County Hospital and any other clinical facility that I am assigned to. I understand that my educational status can be terminated with or without cause at any time, at the option of either this Educational Institution or me.
4. I understand that Harrison County Hospital is a tobacco and alcohol free campus, any use of these may result in immediate dismissal from the education program.
5. I understand that if I am under the influence or suspected of being under the influence of alcohol, prescription drugs or illicit drugs, it may result in my immediate dismissal.
6. I understand that if accepted into the education program, failure to maintain employee and/or patient confidentiality may result in my immediate dismissal.
7. I understand that I am financially responsible for my medical expenses in the event I am injured or become ill while in the course of this class. Harrison County Hospital suggests that you carry private medical insurance.
8. I understand that I am financially responsible for all and any costs for the class I am enrolled in, even if another organization has agreed to pay for my class and materials. Failure to pay all course costs and fees may result in me not being allowed to complete the course.
9. Students may be photographed or video recorded while in class activities. I understand that I will not own any copyright to these photographs or video recordings and further, give my permission for photographs and video recordings to be used in educational and promotional activities without compensation.