EMR Course Application | Londonderry Volunteer Rescue Squad

LVRS EMR Course Application - 2019

Instructions

This is an application to be enrolled in Londonderry Volunteer Rescue’s 2019 EMR Course. The course is being taught by Vicky Collingwood, Doug Friant, Matt Kujovsky and Marge Fish. The instructors will review your application and let you know if you have been accepted as soon as possible. This class is limited to twenty students who must be approved in advance by the instructors. Preference will be given to potential LVRS and Stratton Mountain Rescue members. Thank you for applying.

Name *

Address *

Email *

Preferred Phone Number *

Age *

Will you be over 16 years of age on December 1, 2019

Computer *

Do you have access to a computer and an internet connection that can be used for classwork and tests?

Affiliation *

Are you affiliated with LVRS or Stratton Mountain Rescue?

Organization

If you selected "Another Organization" above, please enter the name of the organization.

Reasons for wanting to become an EMR

Briefly describe why you are interested in becoming an Emergency Medical Responder.

Are you interested in being a member of LVRS?

(Not required)

Have you reviewed the Vermont State EMR testing application? *

To become licensed in the State of Vermont, you must apply to take the examinations. Please review the application and confirm that you are eligible to test. There is a link to the application on the LVRS EMR Course information page.