ANNUAL OEMSCA MEMBER APPLICATION
YOUR NAME *
Your answer
AGENCY NAME *
Your answer
AGENCY WEBSITE *
Your answer
RANK/TITLE AT AGENCY *
Your answer
CONTACT EMAIL *
Your answer
CONTACT PHONE NUMBER *
AREA CODE + PHONE NUMBER
Your answer
MAILING ADDRESS *
ADDRESS, CITY, STATE, ZIP CODE, COUNTY (if applicable)
Your answer
MEMBERSHIP OPTIONS
AGENCY MEMBER: $200/annually
Chief, Director, Chief Executive Officer or Managing Officer of an EMS-only government-based system, or a city/county/regional agency/district that is the non-profit, 9-1-1 EMS agency of a political subdivision. This officer will have the ability to hold office in OEMSCA, as well as the right to cast vote.

AFFILIATE MEMBER: $100/annually
Support staff affilated with an agency member having defined supervisory responsibilities, but who is not otherwise eligible for Agency Membership. Affiliate members have the same benefits as the Agency member; however, they cannot hold OEMSCA office or vote.

ASSOCIATE MEMBER: $35/annually
Any individual employed by an EMS agency (as listed above in "Agency Member") but does not hold a leadership role who has a vested interest in EMS in Ohio and wants to support the mission. Associate members are welcomed to attend the annual OEMSCA conference but cannot hold OEMSCA office or vote.

RETIRED MEMBER: $15/annually
Any retired member of the public EMS-Only service who wishes to support the mission of OEMSCA.

SELECT A LEVEL *
THANK YOU! ONE MORE STEP...
Your application will be reviewed by the OEMSCA Leadership team. Once approved, you will receive an invoice for the fees due. Please do not send payment until you are contacted via email by the OEMSCA Association Manager. Once you have read this, please click SUBMIT.
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