EMT-Basic Class

Held at Siuslaw Valley Fire and Rescue, Florence, Oregon

Important Dates:

4 Aug 17: You must sign-up @ SVFR and agree to terms by 1500 hrs.

7 Sep 17: Mandatory Orientation from 1800 to 2100

25 Sep 17: Class Start Date. Every Mon/Wed/Fri 1800 to 2200 & Select Saturdays 0800 to 1700

Terms:

Member in Good standing
15 full Saturday shifts scheduled by OPS-1
Must pass and certify as an EMT within 3 months or you owe entire amount of class back to SVFR
Must become a qualified WLAD Driver within 1 month of certifying as an EMT
Must continue required training to keep certification
Remain a member in good standing for one year
Member responsible for purchasing text books for the class
Member must obtain Station Captain’s written approval
Must complete SVFR LCC Fall EMT Scholarship application and additional questions

What we offer:

SVFR/WLA will pay ENTIRE cost of the class minus text book fees. This must be purchased before the class and first testing session
Unlimited potential in Emergency Services
A working knowledge of life saving procedures

Contact info & Questions:

FF Pete “Boa” Warren @ ofc: (541) 997-3212 or cell: (541) 991-0437
Email: Boa@svfr.org

EMT-B Class Application

You can download the Application and take it to SVFR Office, or you can use the online form below

Download the Application

EMT-B Class Application

Contact Information

Name First Last

Address

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Cell Phone

Email *

Certifications:

Do you have your Station Captains Approval

YesNo

Station Captains Name

Questions:

Why do you want to become an EMT?

Do you plan on going further than EMT-Basic?

Will you be able to complete this class? This includes having your work schedule compatible with the class times/dates.

Why do you think we should accept you for this EMB-B Class?

Summarize your previous volunteer experience.

Special Skills or Qualifications:

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Terms of this Agreement. All must be adhered to:

1. Member in Good standing
2. 15 full Saturday shifts scheduled by OPS-1
3. Must pass and certify as an EMT within 3 months or you owe entire amount of class back to SVFR
4. Continue Required Training to keep certification requirements
5. Must become a qualified WLAD Driver within 1 month of certifying as an EMT
6. Remain a member in good standing for one year
7. Member responsible for purchasing text books for the class
8. Member must obtain Station Captain’s written approval

Our Policy It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Agreement *

By checking this box and submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted to attend this class, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal and subsequent reimbursement to SVFR for this class.

Verification

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