Account: Your Information

The information provided will be used to establish your personal account and grant you access to the appropriate portions of the NREMT website.

* Denotes Required Field.


 

*Account Information:
Please choose a username and password. They can be anywhere from 6 to 20 characters long. Username and passwords are case sensitive!
*Username:

*Password:
*Verify Password:

*Personal Information
*First name:
Middle initial:
*Last name:

*Contact Information:
*Email address:

*Request User Roles:
I am requesting to use this login as a(n):
Nationally certified EMS professional
Applying to become nationally certified
Program Director
Training Officer
Medical Director
ALS Exam Coordinator
State EMS Official (requires access code)


Please select at least 3 questions below, then provide answers for each question. Your answers must be between 3 and 50 characters long, including spaces and punctuation.


Question #1:
Answer #1:
 
Question #2:
Answer #2:
 
Question #3:
Answer #3:
 

I hereby attest that the above information is true and correct and understand that submission of fraudulent information is subject to disciplinary action.
 

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