Complete your Paramedic Registration Form

  • Documents
  • Demographic Information
  • Complete
Proof of Age

Are you 18 years of age or older?

Yes
No
Submit documentation of proof of age, i.e. driver's license, state-issued ID card, passport, or birth certificate.
One file only.
10 MB limit.
Allowed types: pdf, doc, docx, jpg, jpeg, png.
High School & College Experience
Or last semester attended
Diploma/GED
Copy of your high school diploma/GED.
One file only.
10 MB limit.
Allowed types: pdf, doc, docx, jpg, jpeg, png.
Or last semester attended
Or last semester attended
None/Certificate/Associate/Bachelor/Masters/Doctorate
Were you previously enrolled at Pennsylvania College of Technology in a credit or clock-hour program?
Credit program
Paramedic clock-hour program
No
Current AHA Healthcare Provider CPR Card
Copy of both sides of your current AHA Healthcare Provider CPR Card.
One file only.
10 MB limit.
Allowed types: pdf, doc, docx, jpg, jpeg, png.
Current EMT Certification
Pick one that best describes you
I currently have my EMT Certification.
Please upload below.
I am in process of earning my EMT Certification and it will be completed prior to the start of the program.
You will need to submit your certification once earned.
I do not have an EMT Certification and will not have earned it prior to the start of the program.

You are not eligible for the program at this time. 

Copy of your current PA EMT, AEMT, or NREMT Certification.
One file only.
10 MB limit.
Allowed types: pdf, doc, docx, jpg, jpeg, png.
Employment
Are you applying for an employer-sponsored scholarship?
Yes
No

The future needs you.

If you put more into today, could you get more out of tomorrow? If you create your future at Pennsylvania College of Technology, the answer is yes.

With open and rolling admission, applying is easy.

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