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Mailing Address City ST Z ip Code Total number of students testing Total taking written test at each level? FR EMT-B EMT-E EMT-I EMT-P Instr Total taking Initial EMT Skills? FR Skills? How many students retesting Skills How many retesting per skill? BLS FR Trauma EMT Trauma MEDICAL A student Roster must be sent with the registration fee if applicable or included with this form via email to pemscts@vaems.org Please indicate partner choice on the roster. If none is indicated, this will be assigned. Confirmations will be sent to the address above.
Choose a test site. There is no fee for written testing. There is a $25.00 fee for all initial practical testing and a $25.00 fee for all practical retesting of 2 or more stations, $15.00 for only 1 station. Retests and written only exam students are encouraged to keep the two week registration deadline. If registering late, please call the PEMS office at 804-693-6234 to make sure seating is available. All registrations are contingent on space available. Cancellation less than 30 days prior to scheduled test date results in forfeiture of fees paid. All test sites are subject to cancellation for lack of registrants. Make all checks payable to Peninsulas EMS Council, Inc. Mail the completed registration form with applicable fees to: Peninsulas EMS Council, Inc. P.O. Box 2348 Gloucester, VA 23061. TEST SITE DIRECTIONS (Directions will be mailed with your registration confirmation) §For other Consolidated Test Sites around the state, please visit the Office of EMS Website list HERE§
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