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EMS Application Form

Thank you for your interest in the Paramedic program at Coastal Alabama Community College. Please refer to the Paramedic Application Information Packet found under the Resources tab for more information. Read the entire packet carefully as an application that does not meet all of the requirements is rendered incomplete and will not be considered for admittance. The required number of hours per week varies with each course.

This program is a daytime course with set meeting times. Course days are scheduled around a rotating shift schedule. It is advisable to complete all general education course requirements prior to the start of Paramedic courses. Reliable transportation, a flexible schedule, and willingness to commute to several area hospitals are required.

Entrance into the program will require, and be dependent upon, a physical health examination, criminal background check, immunization and vaccination records, and drug screen. Students must be accepted by clinical affiliates in order to meet program requirements.

You may call the EMS Department at 251-968-3104, if you have further questions. We are pleased that you have chosen Coastal Alabama Community College’s Paramedic program to prepare you for a career in the Emergency Medical Services profession.

Please complete and submit the online form below. A paper application may be available upon request.

Allen Patterson, M.P.A., NRP
Department Chair & Program Director
EMS & Paramedic Education
450 Fairhope Ave.
Fairhope, Alabama 36532
Office: 251-968 -3113
allen.patterson@coastalalabama.edu

 

I. Personal Data

II. Education

Are you currently taking college courses?
Have you previously been admitted to a paramedic program?

If YES, a letter from that program Dean/Director must be sent to the COASTAL ALABAMA COMMUNITY COLLEGE EMS Department indicating you have not been dismissed for disciplinary or unsafe practice. List the college(s), dates attended, and reason for withdrawal. Please see reinstatement policy for further information.

A COPY OF YOUR ACT EXAM RESULTS MUST BE ATTACHED.

III. Employment

Are You Currently Employed?

I understand that completion of this application is a component of the student profile and does not in itself grant admission to the program. I understand a new application must be submitted if I am not selected and wish to reapply. I certify that the information given in this application is true and correct. I understand that providing false information may be deemed sufficient reason to dismiss the student and/or to refuse admission. All application materials become the property of Coastal Alabama Community College. It is the sole responsibility of the applicant to ensure that Coastal Alabama and Coastal Alabama’s EMS Department have received all of the requested documentation. All information must be submitted by the appropriate deadline or the application will be considered incomplete. It is recommended that applicants check with the Admissions Office, at (251) 580-2111, to confirm that their College application and transcripts are on file and up to date.

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