UAF CTC Paramedic Academy

What Campus are applying for? If your campus is not listed, please contact jyurong@alaska.edu) *

First Name *

Last Name *

Address *

Email - This is VITAL! All communication will done through email - make sure this is an account you check frequently! *

Student ID Number (If none state why) *

Social Security Number

Phone *

Emergency Contact (Name and Phone) *

Are you a US Citizen? *

Are you an Alaskan Resident? *

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

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

When (Year) and Where (Agency) did you complete your EMT course? *

EMT Certification - Do you Currently Hold NREMT Certification? *

EMT Certification Upload - Upload a copy of your EMT Certification *

Upload a Copy of your CPR Credential - This MUST be an AHA for HCP Credential *

Admission Essay - Please upload a letter to the admissions committee on why you wish to attend the academy in PDF, RTF, or DOCX *

Resume - Please upload a current RESUME in PDF, RTF, or DOCX format. *

Academic Transript (College)

What is your highest level of education you have COMPLETED (HS Diploma, Associates, Bachelors, ETC). Please include school name and diploma / degree earned. *

Please upload either a copy of a college degree OR your UAF ALEKS Placement Exam scores. *

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

Provide documentation of the following vaccinations.  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) *

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

Application Form