Class Registration

Pre-Registration is now open for our Fall EMT Class @ Clay Fire Dept.

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First and Last Name *

Mailing Address *

City *

State *

Zip code *

Date of Birth *

Contact Number *

Email *

Please Check only one

Original Class / First Time Student taking EMT class
Refresher Class

New York State EMT Number

Please only put you NYS EMT Number here if you know what it is. If you don’t know what it is or if you are unsure or unable to located it on EMT your card, then please leave blank.

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