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14TH DISTRICT - NEW JERSEY STATE FIRST AID COUNCIL
SPRING 2002 EMT BASIC CORE 13 REFRESHER WEEKEND PROGRAMS

CLASS DATES:
MARCH 1, 2, 3, 4, 2002
OR
APRIL 19, 20, 21, & 22, 2002.
(Will not split dates)

CLASSES TIMES:
FRIDAY & MONDAY CLASSES - 6:30PM TO 10:30PM, WITH
SATURDAY AND SUNDAY CLASSES - 8:30AM - 4:00PM,
AT THE MIDDLESEX COUNTY FIRE & EMS ACADEMY,
SAYREVILLE, NEW JERSEY.

COST:
FREE TO VOLUNTEER FIRST AID AND RESCUE
SQUAD PERSONNEL WITH PROPER ELIGIBILITY FORM.
(SEE APPLICATION)

$120.00 - ALL OTHERS.
(CASH OR CHECK MUST ACCOMPANY APPLICATION.
MUNICIPAL/COMPANY VOUCHERS/PURCHASE ORDERS MUST RECEIVE
PRIOR APPROVAL FROM COURSE
COORDINATOR, PLEASE CALL 732-721-9696)

PREREQUISITE:
MUST BE A CURRENTLY CERTIFIED NEW JERSEY STATE EMTB, OR SHOW PROOF OF HAVING BEEN A NEW JERSEY STATE EMT, OR HAVE A NOTIFICATION LETTER FROM THE NEW JERSEY DEPARTMENT OF HEALTH ? OFFICE OF EMERGENCY MEDICAL SERVICES, OF FAILURE TO PASS THE STATE EMT- B CERTIFICATION EXAM
MUST BE CURRENTLY CERTIFIED IN AHA, ARC, OR NSC PROFESSIONAL LEVEL CPR.

MAIL REGISTRATION TO:
Mary-Ann C. Gugliemella, RN, EMTB(I)
66 Schuyler Drive
Edison, New Jersey 08817-3559

REGISTRATION MUST INCLUDE: *A PHOTOCOPY OF YOUR VALID EMTB CARD OR A COPY OF THE FAILURE NOTIFICATION FOR THE EMTB CERTIFICATION EXAM OR PROOF OF PRIOR NJ EMT CERTIFICATION. *A COPY OF YOUR VALID CPR CARD. *THE COMPLETED APPLICATION FORM, SIGNED BY THE SQUAD OFFICER IF A MEMBER OF A VOLUNTEER FIRST AID/ RESCUE SQUAD OR IF NON-VOLUNTEER, THE COMPLETED APPLICATION MUST INCLUDE CASH, CHECK, OR VOUCHER/PURCHASE ORDER FOR $120.00 PER PERSON, WHICH INCLUDES A NON-REFUNABLE $50.00 ADMINISTRATIVE FEE.
CHECKS MUST BE MADE PAYABLE TO: THE 14TH DISTRICT - NJSFAC

INCOMPLETE DOCUMENTATION WILL NOT BE ACCEPTED.

CLASS SIZE IS LIMITED. SO REGISTER EARLY.
REGISTRATION DEADLINE - FEBRUARY 14, 2002 FOR THE MARCH COURSE AND
APRIL 6, 2002, FOR THE APRIL COURSE.