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NUEMS New Member Fall 2020 Application
Please remember to send scanned copies of your EMT card, CPR cert, & driver's license to us by filling out the EMT documents form under the membership tab on the NUEMS website if you are an EMT!
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* Indicates required question
First and Last Name
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Your answer
NU ID #
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Your answer
Year of study at NU (Ex: 3/5)
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Your answer
Husky Email
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Your answer
Phone Number (used for medical detail purposes only)
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Your answer
Are you a Massachusetts EMT or Paramedic?
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Yes
Out-of-state EMT or NREMT working on reciprocity
No
If yes, add your MA EMT # below and send a scan of your EMT cert, driver's license, and AHA CPR Card to us by filling out the EMT documents form under the membership tab on the NUEMS website
Your answer
Are you AHA CPR certified? (not red cross)
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Yes
No, but I would like to be! (If you TA for a CPR class through NUEMS you can get certified for just $10)
No
If so, when does your CPR card expire?
Your answer
Have you requested to join NUEMS on engage? (you must do so prior to submitting this application)
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Yes
No but I am going to do this now!
Briefly describe any EMS experience you have and why you are interested in NUEMS (no experience is necessary to join and all are welcome):
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Your answer
Is there anything special you would like to see happen through NUEMS this semester?
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Your answer
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