2017 - 2018 Paramedic Academy at UAF CTC Paramedic Academy

Thank you for applying to the Paramedic Program. Please take a moment to review ALL of the questions below and gather ALL of the information PRIOR to submitting the application. INCOMPLETE applications WILL NOT be reviewed! Once you have submitted an application it will be reviewed. If all of the application criteria have been met, you will be advanced to the Criminal Background Check and Entrance Exam phases. Please contact carenson@alaska.edu with any questions.

Application Form

First Name *

Last Name *

Address *

Email - the program will communicate through email - make sure this is an account you check frequently! *

University of Alaska Student ID Number (If none state why) *

Phone *

Emergency Contact (Name and Phone) *

Are you a US Citizen? *

Have you *completed* an Anatomy and Physiology Course? *

Are you *currently enrolled* an Anatomy and Physiology Course? *

Please upload your current EMT certificate *

Upload a current Copy of your CPR Credential (must be BLS provider card) *

Upload proof of current health insurance (health insurance must be maintained throughout the course) *

Admission Essay - Please upload a one page paper on why you wish to attend the academy, in one of the following formats PDF, RTF, or DOCX *

Resume - Please upload a current resume in one of the following formats, PDF, RTF, or DOCX *

Have you completed the Pre-Paramedicine core courses for the AAS Paramedicine *

Photo - Please upload a current passport style photo (Face Shot) *

Please upload a current copy of your background check (obtained from AK State Troopers or your home state) *

Provide documentation of the following vaccinations or titer.  Measles, mumps, and rubella (MMR) (2 shot series)  Varicella (2 shot series or blood test to confirm you had the disease as a child)  Hepatitis B series (show proof of Hepatitis B immunity, have started the vaccination series) *

Please upload reference letter 1 (non-family member) *

Please upload reference letter 2 (non-family member) *

Please upload reference letter 3 (non-family member) *

UAF CTC Paramedic Academy

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Application Form