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707 Wild Rose Trail
Cedar Park, TX 78613
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02/25/2012
Soccer Tournament- Austin, TX
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02/26/2012
Soccer Tournament- Austin, TX
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03/03/2012
Explore UT- Austin, TX
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05/12/2011
EMS Network policy updates and location
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04/24/2011
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Events EMS Medic Registration Form
This form is for current medics working in the Central Texas area. The process past this point is to submit a copy of your license and certificates to us. Please note after submission, your account will be in administrative hold until your documents are verified. Also please note that under the event sign-up page events will only be posted if there is a slot open for you. Ensure that you review our
Clinical Operating Guidelines
as you will be tested on them.
*First Name:
*Last Name:
*Mailing Address:
Address 2:
*City:
*State:
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AL
AS
AZ
CA
CN
CO
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*Zip Code:
*Primary Phone:
*Primary Email:
*Password:
*License:
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Emergency Care Attendant (ECA)
Emergency Medical Technician (EMT)
Emergency Medical Technican - Intermediate (EMT- I)
Emergency Medical Technician - Paramedic (EMT-P)
Licensed Paramedic (LP)
Registered Nurse (RN)
Medical Doctor (MD)
Instructor (Instructor)
*Number:
*Expires:
February, 2012
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*CPR Expires:
February, 2012
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*SSN:
Bike Medic:
Experience:
I agree with the
terms and conditions
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