GERMS Summer 2019 EMT Course Application
All applicants should attend one information session. If you do not attend an information session, please reach out to training@georgetownems.org for an informational powerpoint. For more information, go to http://www.georgetownems.org/classes/

Applications are due on Thursday, May 23rd at 11:59 pm. Interviews will be held on Sunday, May 26th. Skype interviews will be available during the times listed.

Email address *
What is your first name? *
What is your last name? *
What is your phone number? *
Do you qualify as a Georgetown University affiliate? (student, alumni, university employee, MGUH hospital employee) *
If you do qualify as a GU affiliate, please state your affiliation (student school/major, graduation year, GU employee, etc). If you do not qualify, please leave blank.
If you are not a GU affiliate, please state your occupation.
If you are a Georgetown undergraduate student and you would like to apply for a scholarship, please write your student ID number (see information form from information session for details):
If you are a Georgetown undergraduate student, are you a part of GSP?
Will you be at least 18 years old by July 28, 2019? *
Have you ever been convicted of a felony? *
If you have ever been convicted of a felony, please explain the charges here. If not, leave blank.
List any other commitments you have during June and July (jobs, classes, volunteer positions, family obligations, etc.). Include the approximate number of hours per week needed for each obligation. *
If you a student, please include the credits you plan to take this summer.
Do you have any prior experience in medicine or healthcare? If so, please list those experiences below. (no more than 250 words) *
Why do you want to become an EMT? (no more than 250 words) *
How would taking this class enhance your life? In other words, why do you want to take this class, and what do you want to do with the things you learn from it? (no more than 250 words) *
If you are given an interview, what timeframe(s) would you be able to be interviewed on Sunday morning (05/26/2019)? *
Required
If you would like to have your interview be a Skype interview or Phone Interview, leave your phone number or Skype Username
Have you applied for the GERMS EMT class before? *
Is there anything else that you would like to tell us? Please state it here if so.
A copy of your responses will be emailed to the address you provided.
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