EMT Part 2 Registration

Course Options
Select type of format for Part 2*
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Skill Week
Choose Skill Week dates*
Skill Week takes place at our training facility in Edina, MN. You must be able to attend all days and sessions in person. Please let us know if you need lodging recommendations! Skill Week schedule is Monday-Friday 8:30a-4:30p and Saturday 8:30a-around 5p.
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Alternate Skill Week*
Choose a backup spot in an additional Skill Week in case a spot does not open up for you in the waitlisted Skill Week.
Choose dates of Evening Skills*
Evening Skills takes place at our training facility in Edina, Minnesota. You must be able to attend all sessions in person. Evening sessions are held from 6:30p-10p.
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Evening Skills M/W
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Evening Skills T/Th
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Evening Skills Monday/Wednesday
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Evening Skills Tuesday/Thursday
Include CPR Certification?*
EMTs are required to be CPR certified at the Healthcare Provider level (this level of certification is called BLS for Healthcare Providers). This is offered during the course for those who need it.
When does your CPR certification expire?*
Please bring your CPR certification card to the first day of class.
Student Information
Full Name*
First Last
Preferred Name (optional)
We will use this instead of your first name when printing your name badge (i.e. Nick instead of Nicholas)
First
Email Address*
Please use the same email address as the one used to sign into courses.alliedmedtraining.com.
Enter Email Confirm Email
Alternate Email Address
If you sometimes use a different email address, please enter it here.
Enter Email Confirm Email
Phone Number*
Just in case we can't reach you by email.
Mailing Address*
Street Address City State ZIP Code
Anything else you'd like us to know?
Payment
Discount 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/Debit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Invoice to Sponsoring Organization
Did your organization give you an ID code to enter when registering?*
Organization ID Code*
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Organization Name*
Name of Organization*
Contact Person at Organization*
First Last
Phone of Contact Person*
Email of Contact Person*
Email address Confirm email
Mailing Address of Organization*
Street Address Address Line 2 City State ZIP Code
Instructions 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).
Agreement & Signature
Invoice Terms and Conditions*
- I understand and agree that the organization above has authorized payment for my course fees, and I will NOT receive course completion verification until payment is received.
Online Course Completion Requirement*
- I understand and agree that I will not be allowed to attend Part 2 if I have not completed and passed Part 1 at least one week before the start of Part 2.
Location of Part 2*
- I understand and agree that after successfully completing Part 1 online, I will need to physically attend Part 2 at Allied's training facility in Edina, MN.
Part 2 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
Terms and Conditions*
- I understand and agree to the TERMS AND CONDITIONS
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Signature
Signature of Student*
By typing my first and last name below, I verify understanding and agree to the terms and conditions of this course. I also verify that the person completing this form is the student enrolling in the course.
First Last

Registration for Part 2 of Self-Paced EMT Course

Course Options

Student Information

Payment

Invoice to Sponsoring Organization

Agreement & Signature