Registration Information

Student Application

First Name

Last Name

NREMT Psychomotor Authorization to Test ID (PATT)

Phone Number

Date of Birth (MM/DD/YYYY)

SSN (Only for VA benefits)

Address 1

Address 2

City

State

ZIP

Credit Card Number

Credit Card Exp (MM/YY)

Credit Card Billing ZIP

Deposit / Payment

Applications have a deposit of $350 which is used towards tuition. You may opt to pay more or pay off the class now.

Comments

We will process your payment and application within 48 business hours.