emergency medical technician program applicant information guide

emergency medical technician program applicant information guide
Eastern Arizona College
615 N. Stadium Ave.
Thatcher, AZ 85552
Phone: 928-428-8502
Website: http://www.eac.edu/Academics/Programs_of_Study/Paramedicine/
Eastern Arizona College offers an Emergency Medical Technician education program for qualified
candidates. Completion of all courses in the program enables the student to petition for the certificate of
proficiency in Emergency Medical Technician from the college. However, completion of the EMT 103 –
Emergency Medical Technician course prepares the student to sit for the national examination for
Emergency Medical Technicians. EMT 103 is offered each fall, spring and summer semester. Other
courses offered within the EMT program are listed below. The goal of the Eastern Arizona College
Emergency Medical Technician Program is to prepare competent entry-level EMT's in the cognitive,
psychomotor and affective learning domains.
Candidates interested in completing the certificate of proficiency in Emergency Medical Technician
must complete the following courses in addition to completing EMT 103:
BIO 160 – Introduction to Human Anatomy and Physiology OR
BIO 201 and BIO 202 – Human Anatomy and Physiology I & II
EMT 121 – Cardiopulmonary Resuscitation
EMT 170 – Vehicular Extrication and Trauma Care
HCE 112 – Medical Terminology
All courses must be completed with a grade of “C” or better.
Entry into the EMT program requires formal admission before the candidate can register for courses. For
more detailed procedures regarding admission, please contact the EMS Department at 928-428-8502.
We appreciate your interest in the EMT Program and hope the following information will help you
determine whether you are currently qualified for admission to the program. If you feel you are qualified,
an application is included in this packet. Complete the application and bring it with supporting
documentation to NC8. This packet is also available for download from our web page or you can obtain
it via email from Sonda Bryce at sonda.bryce@eac.edu. Qualified applicants are admitted based on a first
come first serve basis. Each EMT course is limited to 24 students.
Eastern Arizona College EMT Program Application
Revised 4-2017
Completed applications (with required documentation of all application requirements) must be submitted
to the Eastern Arizona College EMS Office, located at North Campus 8 by 5:00 PM, May 1st for
admission into the summer semester, August 1st for admission into the fall semester and January 1st for
admission into the spring semester. Applicants are responsible for verifying completeness of their files by
the date required by contacting the EMS Department at 928-428-8502.
Note: Late applications may be accepted. Applicants will be placed in the class in the order that
applications are received. Class size is limited to 24 students. Any applicants after number 24 will be
placed on an alternate list.
All applicants must meet the following qualifications at time of application:
1. Completed Emergency Medical Technician Program Application for Admission (Can be completed
electronically and printed).
2. Proof of applicants age (All applicants must be 18 years of age or over)
3. High school graduate or GED.
4. Current AHA BLS Healthcare Provider card or proof of concurrent enrollment in EMT 121.
5. Proof of completion of ENG 113, College Reading, or proof of at least a 10th grade reading level on
College approved assessment test. *Your EAC reading assessment test score is available on Gila
Hank online or from your advisor.
6. Arizona DPS fingerprint clearance card.
*Receipt of payment to DPS will be accepted with your application, until a copy of the fingerprint
card can be submitted to the program director. Application for the fingerprint clearance card is found
online at: http://www.azdps.gov/services/fingerprint
7. Proof of all immunizations included on the Student Health Requirements Checklist (See
8. Current health insurance coverage that must remain current throughout the course of training and
certification process.
Eastern Arizona College EMT Program Application
Revised 4-2017
BIO 160, Introduction to Human Anatomy and Physiology, 4 credits OR
BIO 201 and BIO 202, Human Anatomy and Physiology I & II, 8 credits
EMT 103, Emergency Medical Technician, 9 credits
EMT 121, Cardiopulmonary Resuscitation, .5 credits
EMT 170, Vehicular Extrication and Trauma Care, .5 credits
HCE 112, Medical Terminology, 2 credits
Prices stated above are strictly figuring $80/credit. Taking more than one course over the duration of a
semester and other factors will change the total cost for tuition. For accurate estimates of total program
costs, please contact the EMS Department or Counseling Department.
Emergency Care, 13th Edition
ISBN: 9780134024554
In addition to tuition, fees and textbooks for the course, the following additional
costs will be required in order to successfully complete the EMT 103 course:
Class Uniform
MyClinicalExchange Registration
Fingerprint Card
Drug Screening Test
Additional Immunization Requirements per Clinical/Vehicular site requirements
Develop good communication and people skills with an emphasis on development of good patient
Develop STRONG leadership skills. Learn to delegate and give direction to others in a decisive
manner without being too abrupt.
The EMT course requires a huge time commitment. Make sure you are ready to commit the
time, energy to your education. Don’t fall behind.
Find a study regimen that works for you and stick with it.
Be dedicated to your education and to the program. Make becoming an EMT your #1
Application deadline:
January 1st for Spring Semester
May 1st for Summer Semester
August 1st for Fall Semester
Eastern Arizona College EMT Program Application
Revised 4-2017
Emergency Medical Technician Training Program
1. Applicant:
Name: (First)
2. You must complete a Student Health Requirements Checklist and attach necessary
documentation. (attached)
3. You must attach a copies of the following:
☐Current AHA BLS Healthcare Provider Card (Front and back)
☐Proof of enrollment in EMT 121 section
☐Copy of Driver’s License
☐Copy of reading assessment scores
☐Copy of Fingerprint Clearance Card
☐Copy of current health insurance coverage
I certify that all the information provided by me is true, complete and accurate. I am
responsible for provision of all requested information. Failure to provide proper
documentation may adversely affect my admission into the program.
I hereby further authorize and consent to the release of information by this college,
hospitals or other departments as appropriate regarding information relevant to the
training program as long as such release of information is done in good faith and
without malice, and I hereby release from liability Eastern Arizona College and its
representatives for so doing.
I understand that Eastern Arizona College and their clinical/vehicular sites acknowledge
that certain information pertaining to the condition and care of patients is confidential
and, unless waived by the patient, is entitled to protection from disclosure under the
Applicant Signature:
Completed applications with supporting documentation can be submitted to the EMS
Department at NC8, mailed to the EAC EMS Department at 615 N. Stadium Ave. Thatcher,
AZ 85552 or submitted via email to evelyn.hallford@eac.edu.
Eastern Arizona College EMT Program Application
Revised 4-2017
Please complete all the requirements listed below. You may meet the requirement with one of the listed
suggestions. All requirements require submission of documentation to prove fulfillment of the requirement.
MMR (Measles/Rubeola, Mumps & Rubella):
Documentation of positive IgG titer for Measles/Rubeola, Mumps and Rubella.
If any of the titer results are NEGATIVE or EQUIVOCAL, you must get your first MMR vaccination and
provide proof of documentation. The second MMR must be completed after 28 days and documentation
Documentation of completion of one series of MMR immunizations. One “series” of immunizations
includes two immunizations for each disease on separate dates at least 28 days apart (at least 4 weeks).
VARICELLA (Chicken Pox)
I. Documentation of positive IgG titer for Varicella or documentation of history of the active disease.
This must be documented by a physician or health department records.
If any of the titer results are NEGATIVE or EQUIVOCAL, you must provide proof of your first Varicella
vaccination and documentation of the second vaccination completed 30 days later.
Documentation of completion of one series of Varicella immunizations. One “series” of immunizations
includes two immunizations at least 30 days apart.
Tuberculosis (TB)
Documentation of initial completion of a negative Two-Step TB Skin Test or negative IGRA. Two-step
TB Skin Test consists of an initial TB skin test and a boosted TB skin test 1-3 weeks following the first
*If TB skin test results are POSITIVE, documentation of a clear chest X-ray is required. If chest xray is POSITIVE, further referral to a county public health and treatment documentation is
Hepatitis B
Documentation of a positive HbsAB titer
Documentation of Hepatitis B immunization series x2 if not covered to positive HbsAB titer on the first
series. One “series” of Hepatitis B immunizations includes three injections, an initial injection
followed by a second injection given 1 to 2 months after the first dose and a third injection 4 to 6
months after the first dose).
Signed Declination form
Influenza Vaccine (Flu Shot)
Documentation of recent immunization
Signed medical or religious exemption form. This will require that a mask be worn during the
designated flu season.
Tetanus/Diphtheria/Pertussis (Tdap)
A one-time adult dose of Tdap (age 19 or older), followed by a Td booster every 10 years after 5 years
in the event of a needle stick exposure. Tdap=Tetanus/Diphtheria/Pertussis, Td=Tetanus/Diphtheria
10 Panel Drug Screen
Eastern Arizona College EMT Program Application
Revised 4-2017
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