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  • Application For Admission To ALS Program

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    This document is an application for emergency medical technology programs at Tidewater Community College. It requests information such as name, address, contact details, program of interest, and documents required for admission such as a current EMT card, CPR certification, proof of vaccinations, physical exam, and background check. The application is for day, night, or accelerated ALS EMS programs in cities including Virginia Beach, Newport News, Hampton, Portsmouth, and others. Required documents are due prior to or on the first day of class or before starting clinical/field work depending on the program.

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    Application for Admission to ALS Program

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    This document is an application for emergency medical technology programs at Tidewater Community College. It requests information such as name, address, contact details, program of interest, and documents required for admission such as a current EMT card, CPR certification, proof of vaccinations, physical exam, and background check. The application is for day, night, or accelerated ALS EMS programs in cities including Virginia Beach, Newport News, Hampton, Portsmouth, and others. Required documents are due prior to or on the first day of class or before starting clinical/field work depending on the program.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    15 views1 page

    Application For Admission To ALS Program

    Uploaded by

    ps23435
    This document is an application for emergency medical technology programs at Tidewater Community College. It requests information such as name, address, contact details, program of interest, and documents required for admission such as a current EMT card, CPR certification, proof of vaccinations, physical exam, and background check. The application is for day, night, or accelerated ALS EMS programs in cities including Virginia Beach, Newport News, Hampton, Portsmouth, and others. Required documents are due prior to or on the first day of class or before starting clinical/field work depending on the program.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    of 1

    Day Program

    Virginia Beach
    Newport News
    Tidewater Community College Night Program

    Hampton Emergency Medical Technology


    Portsmouth Application for ALS EMS Programs
    Other: Specify ___________

    Application Date: ______________________ Semester: ____________________________

    Only Intermediate Paramedic Accelerated I99 PM Both


    Critical Care only EMT-Enhanced (must have proof of EMS agency sponsorship)

    Last Name: _________________________ First Name: ________________________ SSN: ______________________

    Mailing Address:___________________________________________________________________________________

    Contact Information

    Home: ____________________ Work: _____________________ Pager: ____________________

    Cell: ____________________ Fax: ________________ E-Mail: __________________________

    Sponsoring Agency if Applicable: ___________________________________________________

    Contact Person: ___________________________ Phone #: __________________________

    Due prior to or on first day of class: (accelerated programs send with application to secure seat)
    TCC admission application (available at www.tcc.edu)
    Copy of current EMT card
    Copy of CPR (Professional Rescuer or Healthcare Provider) EMP # ________________
    Proof of High School Graduation or GED Equivalent
    (student ID number)
    Copy of Driver=s License or other proof of age over 18 years

    Due before starting clinical / field: (accelerated programs due 1st day of class)

    Current physical exam to include a respiratory physical (done within last 2 years)
    available at http://www.tcc.edu/academics/divisions/healthprofessions/ems/physical.pdf
    Current PPD (tuberculin) skin test (within last 8 months)
    Proof of Varicella (chickenpox) immunity (by lab results or proof of vaccine)
    Proof of MMR (measles, mumps, rubella) vaccine since 1980 or proof of immunity
    Proof of tetanus toxoid vaccine within 10 years or proof of waiver
    Recommended: Hepatitis B vaccine series (bring verification)
    Criminal, sex offender, crimes against minors background check

    Send requirements to:

    Tidewater Community College


    757 822-7335
    Emergency Medical Technology
    Fax: 822-7557
    Attention: Lorna Ramsey
    lramsey@tcc.edu
    1700 College Crescent
    Virginia Beach, VA 23453

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