Alabama EMS Association
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1 year AEMSA only - $30
1 year AEMSA and NAEMT - $60. ($10 dollar discount from NAEMT)
Membership Benefits
Membership Application
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Indicates required field
Name
*
First
Last
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Organization
*
Phone Number
*
Current Certification Level - Active Member
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Paramedic
AEMT
Intermediate
EMT
EMR
Associate Member
*
Active Member - see list above
Retired EMS practitioner
EMS Educator
Physician
RN/Health Services (PT, RDH)
Other
Participation
*
Full Time
Part Time
Volunteer
Retired
Not Currently Employed
Service Type
*
FD
Rescue Squad
Private ambulance
Critical care transport
Industrial/commercial
County/municipal
PD
Military
Air Medical
Health Agency
Hospital
Other
Select all that apply
Specialty Certifications
*
CCP-C
FP-C
TP-C
Other
Select all that apply
Primary Job
*
EMT
Paramedic
EMS Educator/FTO
EMS supervisor
EMS Manager
Nurse
Firefighter Medic
Dispatcher
Critical Care/Flight Medic
Medical Director
Physician
EMR
Other
Certification State
*
NREMT Certification #
*
Required for registration for NAEMT
State License #
*
Exp. Date
*
As required for registration for NAEMT
Exp. Date
*
MM\DD\YEAR
Type of Application
*
Initial
Renewal
Current NAEMT Membership #
*
Payment
Home
Membership
Membership Application
Events
About
Mission Statement
Board and Officers
History of AEMSA
Contact Us
Links Page
Alabama EMS Association
