Class Registration

Registration is now open for our Fall EMT Class @ Nedrow Fire Dept.

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Your First Name *

Your Last Name *

Your Mailing Address *

City *

State *

Zip code *

Contact Number (Perferably Mobile number) *

Date of Birth *

Email address you look at everyday *

If you have New York State EMT Number please put it below if not then leave blank

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.

Please Check only one

Original Class / First Time Student taking EMT class
Refresher Class

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