ACADEmy In-Person EMT Application

ACADemy In-Class EMT Enrollment Application
Address
City
State/Province
Zip/Postal
Country
Men’s and Women’s sizes are available, please make sure to indicate if you want men’s or women’s sizing.
If yes, please attach a separate page giving a brief description of the incident. Include dates and penalties assessed.

EMERGENCY CONTACT INFORMATION

Required Enrollment Documents

Maximum file size: 20.97MB

Maximum file size: 20.97MB

Maximum file size: 20.97MB

Acceptable documents include: high school diploma, high school transcripts, college transcripts (MUST have high school name and graduation year on them), GED certificate. We cannot accept college diplomas or college transcripts that do not have the high school name and graduation year listed

Maximum file size: 20.97MB

Please go to https://www.patientnotebook.com/adaircountyambulancedistrict/payment to complete your online payment and pay in full or make the initial 3 part payment. Please Save your receipt and attach it here for proof of payment.

I understand that falsifying any records pertinent to this application can lead to ineligibility or immediate dismissal from the program. My signature below attests that the information contained on this application is true and accurate to the best of my knowledge. I also understand that I will have access to a digital copy of the textbook, but will not receive a “physical” text. If I would like to purchase one I can use the below link to do so:

http://www.jblearning.com/cart/Default.aspx?bc=08017-9&ref=psg&coupon=PSGQ119
I certify that the PRINTED NAME below is my ELECTRONIC SIGNATURE.

http://www.academs.us/2022/08/25/4424/

Adam Bruner Memorial Scholarship


The Adam Bruner Memorial Scholarship has been established in memory of Paramedic Adam Bruner. Adam was a dedicated EMS professional who served the citizens of Adair County and beyond for many years. Adam was incredibly passionate about EMS education and was always helpful in training, leading and precepting new EMTs and Paramedics. This scholarship has been established in his name to continue Adam’s passion and legacy within Adair County and EMS education.


The Adair County Ambulance District Adam Bruner Memorial Scholarship Committee accepts applications for Emergency Medical Technician (EMT) Courses and Paramedic Courses through the ACADemy at the District.

Scholarship applicants must meet the below Qualifications:

EMT:

18 years of Age

High School Graduate or GED

Live in a County located within Region B which includes, Adair, Chariton, Clark, Knox, Lewis, Linn, Macon, Marion, Monroe, Putnam, Ralls, Randolph, Schuyler, Scotland, Shelby, and Sullivan.

Paramedic:

Same as for EMT but must also already be a Nationally Registered EMT


Interested candidates should apply by clicking the button to apply or questions about the program should be emailed to academy@academs.us


http://www.academs.us/2022/01/13/4223/

http://www.academs.us/2022/01/13/4219/

ACADEmy Preliminary Paramedic Application

Thank you for your interest in the Paramedic Program at the ACADemy.
Please fill out this preliminary application and we will contact you via e-mail for further information.

ACADemy Preliminary Paramedic Application

Personal Information

Address
City
State/Province
Zip/Postal
Country

Education

Other Education (vocational training, college, etc.)

EMS Education

Work History

Ems Related Certifications

If yes, please attach a separate page giving a brief description of the incident. Include dates and penalties assessed.
If yes, please attach a separate page giving a brief description of the incident. Include dates and penalties assessed.