EMT-Basic Practical Registration
SC Midlands EMS Management Association
3201 Leaphart Road
West Columbia SC 29169
Instructions for Basic Practical Testing
Cost for first time testing is $25.00 per station Total of $100.00
We do NOT accept personal checks – we do accept credit card payments, a money order or a cashiers check payable to Midlands EMS
Money is due in our office one week prior to exam. Please make sure you have sufficient time for mail. Students should not come by our office to pay.
The completed form below should accompany your testing fees.
You should arrive at this office on the morning of your test at 8:30am no later than 8:45. You must present proper ID to the National Registry Representative
Students that are not checked in by orientation at 9:00am will not be allowed to test.
If unable to attend after payment is made please notify this office and we will move you to another date.
Please Print Clearly
Student Name______________________________Phone Number______________________
School Attended______________________________________Last 4 digits SS#__ __ __ __
SC # SC_________________ (from CIS)
_______Airway ______Assessment ______CPR/AED _________________Random Skill
If repeat make sure you list skill to repeat