Join PANJEMS

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Join PANJEMS

PANJEMS Member Application

First Name *

Last Name *

I am currently a... *

MICP - Active

MICP - Former/Retired

MICN - Active

MICN - Former/Retired

None of the Above

Other:

How many years have you been a NJ MICP/MICN? *

How many places are you currently employed as a MICP/MICN? *

Former/Retired Paramedic

Please select which paramedic department(s) you work for: *

Atlantic Health

AtlantiCare

Capital Health

Cooper

Englewood

HMH - HUMC

Holy Name

Hunterdon

Inspira

HMH - JFK

Robert Wood Johnson

St. Clare's

St. Joseph's

UMDNJ

Valley

Virtua

Retired

Other:

Required

What is your MICP/MICN Number? *

What is your NJ OEMS Number? *

What is your email address? *

What is your cellphone number?

I am interested in the following: *

Interacting with NJ Legislators

Serving on the PANJEMS board

Mentoring paramedic students

Mentoring EMT students

Being involved in the conversation within PANJEMS

Receiving the PANJEMS newsletter

Assisting in creating a database of MICP pay within the state of NJ to aid MICPs in getting fair market adjustments

Just being a member

Other:

Required

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