2018 - 2019 Paramedic Academy at UAF CTC Paramedic Academy

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

See all the jobs at UAF CTC Paramedic Academy here: http://alaska.recruiterbox.com/jobs

Application Form