EMT Online Application Form

Thank you for your interest in registering for the EMT program. Please use this form to submit either via check, money order or credit card. Your registration cannot be processed until the fee is received. Please mail payment to:

Reading Health School of Health Sciences
Emergency Medical Services Programs
PO Box 16052
Reading, PA 19612

For more information, please contact the school at 484-628-0100.
* Denotes required fields

EMT (technician)

* Please choose the class you wish to attend

Sponsorship Information

Are you being sponsored by an organization?

Your Contact Information

* Are you at least 16 years of age?

Citizenship

* Are you a United States citizen?
Non-US citizens: Are you a permanent US resident?

The following information will be used solely for reporting purposes. This information will not be used in the admission process.

Gender

Understanding

Submission of my registration indicates my understanding of all academic requirements and materials required for the EMT program. I further signify that the information given is, to the best of my knowledge, accurate and correct. Permission is hereby given to Reading Hospital School of Health Sciences to investigate all pertinent information regarding my application. If accepted, I agree to inform the school of any changes to the information I have provided on the application prior to and after acceptance into the school. Moreover, I understand that giving false information or withholding information prior to or after acceptance into the school may make me ineligible for admission or to continue my enrollment at Reading Hospital School of Health Sciences. I have read and understand the information included in the registration. I understand that the registration fee of $30 is non-refundable and required for processing my application.

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Payment Type

* How do you wish to pay for your $30 application fee?