1Student Information

2Registration Options

3Agreement & Payment

Student Information
Full Name*
First Last
Preferred name / nickname (optional)
If you commonly go by another first name, please enter it here.
Email Address*
Please use your personal email address rather than a work or school account. Course instructions will be emailed to this address, and it will also become your username for logging into the online course.
Enter Email Confirm Email
Do you use a second email address?
If you sometimes use an alternate email, like a work or school account, please enter it here.
Enter Email Confirm Email
Phone Number*
Just in case we can't reach you by email.
Country of Residence*
And your mailing address?*
Please note the state of New York does not accept our courses.

Street Address Address Line 2 City State ZIP Code
And your mailing address?*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
T-Shirt Size*
Unisex sizing. A soft, washable branded shirt that's given to you at the first session of Part 2.
Do you intend to gain EMT certification with a specific State?*
Which State?*
Choose the state you intend to apply for EMT certification. Note students are responsible to verify the requirements for becoming EMT certified in their own state - some states may have additional requirements beyond NREMT certification.

State
New York does not allow hybrid learning.*
Unfortunately, New York state does not accept EMT courses that contain online learning in any amount.
- I understand that this course will NOT be accepted by the state of New York, but I would like to take it anyway.
Ohio - additional EMT training requirement*
Ohio requires EMT candidates to receive training in dual lumen and extraglottic airway from an Ohio-approved training program before they can become certified in Ohio.
- I understand that I must complete this additional training through an Ohio-approved program.
Hawaii - additional EMT training requirement*
Hawaii requires EMT candidates to obtain NREMT certification plus additional training in advanced skills and at least 96 hours of supervised clinical experience with a Paramedic. You may still take our program to become eligible for NREMT certification as an EMT, but you will need to obtain the Hawaii-specific training and clinical experience elsewhere.
- I understand that I must complete additional training and clinical experience elsewhere through a Hawaii-approved program.

Agreement & Signature
Course Time Commitment*
- I understand and agree that at least 100 hours of learning and self-study is needed to complete the online coursework, and the deadline for finishing the online coursework is one week before the start of Skill Week.
Part 1 (Online Course) Refund Policy*
- I understand and agree that there is no refund of Part 1 tuition under any circumstances after 15 days from today as documented in the TERMS AND CONDITIONS
Part 2 (Skill Week) Refund Policy*
- I understand and agree that there is no refund of Part 2 tuition under any circumstances as documented in the TERMS AND CONDITIONS
Location of Part 2 (Skill Week)*
- I understand and agree that after successfully completing Part 1 online, I must physically attend Part 2 at Allied's training facility in Minnesota.
Payment
Promo Code
Northwestern Health Verification*
- I verify that I am currently a student or faculty/staff member of Northwestern Health Sciences University.
Total
$0.00
Payment Method*
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Invoice to a Sponsoring Organization
Did your organization give you a code to enter when registering?*
Organization ID Code*
Name of Organization*
Contact Person at Organization*
First Last
Phone of Contact Person*
Email of Contact Person*
Enter Email Confirm Email
Mailing Address of Organization*
Street Address Address Line 2 City State ZIP Code
Instruction for Submitting Invoice
Enter any specific instructions we should know about submitting an invoice to this organization (for example: what to include in the memo, etc).
Invoice Terms and Conditions*
- I understand and agree that the organization above has authorized payment for my course fees, and if payment is not received by the due date indicate in the invoice, my course registration will be canceled.

EMT Self Paced V2

Student Information

Registration Options

Agreement & Signature

Payment

Invoice to a Sponsoring Organization

EMT: Self-Paced Course Registration

Step 1 of 4Next: Student Information

Registration Options

Student Information

Payment

Agreement & Signature

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