EMT Training Signup Signup for an EMT Class using the form below. You must have JavaScript enabled to use this form. Participant First Name Participant Last Name Phone Number Email Email Confirm email Department/Agency Please enter the name of your department/agency. If you are not a member of an agency, please enter "No Agency" Training Class Options - Select - Student type Original Student for NYS EMT/CFR Classes = Never have been certified to at least the level of Care of the course you are enrolling in. Refresher Student for NYS EMT/CFR Classes = Currently certified or have been previously certified (certification has expired) to at least the level of care of the course you are enrolling in. If enrolling into a CME Core Hour Class, you must be currently certified. Original Student Refresher Student Unknown/Not Applicable Terms & Conditions By checking this box I acknowledge that I have read and agree to the following terms and conditions. FOR CFR/EMT & CME COURESES I agree to download, print, and have my fire chief (or EMS administrator for independent EMS agencies) sign the DOH 3312 Verification of Membership form and the EMS Course Notice of Liability that is provided on this website. The DOH 3312 form allows for State reimbursement to pay for the cost of the course, if certain criteria is met. This completed and signed form must be presented to the course instructor on or before the second class session or the student risks being removed from the course. The Notice of Liability form acknowledges that your fire chief (or EMS administrator for independent EMS agencies) approves your enrollment into the course and that your fire department/ems agency recognizes your participation as training and will be covered by your fire department's/ems agency's insurance. If I am not affiliated with an EMS agency, I understand that I will be responsible for the cost of the tuition of the course. FOR ALL COURSES I agree to attend all scheduled classes for this course. Students that do not attend all sessions of this course without the consent of the instructor for their absence may be subject to expulsion from the course and review for permission to attend future training in the county. I agree to notify the Office of Emergency Services if for any reason I wish to cancel my registration for this course. I Agree to the above Terms & Conditions
