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EMT-Basic Practical Registration |
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SC Midlands EMS Management Association 3201 Leaphart Road West Columbia SC 29169 www.midlandsems.com
Instructions for Basic Practical Testing
Cost for first time testing is $20.00 per station Total of $80.00
We do NOT accept personal checks – Must be money order or cashiers check payable to Midlands EMS
Money is due in our office one week prior to exam. Please make sure you have sufficient time for mail. Students should not come by our office to pay.
The completed form below should accompany your testing fees.
You should arrive at this office on the morning of your test at 8:30am no later than 8:45. You must present proper ID to the National Registry Representative Students that are not checked in by orientation at 9:00am will not be allowed to test.
If unable to attend after payment is made please notify this office and we will move you to another date.
Please Print Clearly
Student Name______________________________Phone Number______________________
School Attended______________________________________Last 4 digits SS#__ __ __ __
Instructor___________________________________________Course #_____________________
Completion Date_________________
_______Airway ______Assessment ______CPR/AED _________________Random Skill If repeat make sure you list skill to repeat |