Pelham Training Course Registration Form
Upon receipt of your registration form, Pelham Training will send a welcome letter with attachments via e-mail to the e-mail address you have listed on your registration form. Depending on how you have your e-mail inbox configured, this important email may go to your junk mail folder. If you have not received your welcome letter within 2 business days of transmitting your application to us, please check your junk mail folder. If after doing so you still have not received your welcome packet, please contact us immediately.

All students attending EMT class (either format) must apply for a PSID # from the Indiana Department of Homeland Security. You MUST have your PSID # prior to the beginning of class. Students attending EMT class from places outside Indiana are still required to have a PSID # prior to the beginning of class. There are no exceptions. Complete information on how to apply for your PSID # will be included with your welcome letter.

Methods of Payment: Payment is due in full in advance of your class start date with the exception of Standard Format Paramedic, Standard Format EMT, and Accelerated Paramedic classes. Paramedic payment schedules will be included in your acceptance letter.

Student Information (All Fields Required)

First
Last
City
State/Province
Zip/Postal
Country

Certifications

If you currently hold an EMT-B, EMT-A, EMT-I or EMT-P certificate, please complete the following section.

Course Information: Please indicate which course(s) you would like to take and be sure to indicate your preferred start date(s) in the Start Date column.