Registration Student Registration Student registration form. Username(Required) Please create a unique username which you will use to login to this site. Please DO NOT use your email address. Once your userame is created, it cannot be changed.Name(Required) First Last Email(Required) Enter Email Confirm Email Password(Required) Enter Password Confirm Password Strength indicator Set a Good password. Your password should be at least 8 characters long and include at least one number and special character.Mailing Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mobile Phone(Required)Certification(Required)Select Certification LevelCFREMT-BEMT-CCEMT-PPlease choose your level of certificationEMT No.(Required) Please enter your EMT number.HiddenOLD EMT No Field (hidden)Please enter your EMT numberCertification Expiration(Required) MM slash DD slash YYYY Please choose your certification expiration date.Primary Agency(Required)Choose Your AgencyAmagansett Fire DepartmentAmityville Fire DepartmentBabylon Fire DepartmentBayport Fire DepartmentBayshore Brightwaters Volunteer Rescue AmbulanceBohemia Fire DepartmentBrentwood Legion Ambulance ServiceBridgehampton Fire DepartmentBrookhaven National Labs Fire-RescueCenter Moriches Fire DistrictCentereach Fire DepartmentCenterport Fire DepartmentCentral Islip - Hauppauge Volunteer AmbulanceCold Spring Harbor Fire DepartmentCommack Volunteer AmbulanceCommunity Ambulance CompanyCopiague Fire DepartmentCoram Fire DepartmentCutchogue Fire DepartmentDeer Park Fire DepartmentDix Hills Fire DepartmentEast Brentwood Fire DepartmentEast Farmingdale Fire CompanyEast Hampton Village AmbulanceEast Islip Fire DepartmentEast Marion Fire DepartmentEast Moriches Community AmbulanceEast Northport Fire DepartmentEast Quogue Fire DepartmentEaton's Neck Fire DepartmentExchange Ambulance of the IslipsFair Harbor Fire DepartmentFarmingville Fire DepartmentFishers Island Fire DepartmentFlanders-Northampton AmbulanceGordon Heights Fire DepartmentGreat River Fire DepartmentGreenlawn Fire DepartmentGreenport Fire DepartmentHalesite Fire DepartmentHampton Bays Volunteer AmbulanceHauppauge Fire DepartmentHolbrook Fire DepartmentHoltsville Fire DepartmentHunter EMS - GMRHuntington Community First Aid SquadIslip Fire DepartmentIslip Terrace Fire DepartmentJamesport Fire DepartmentKings Park Fire DepartmentL.I. MacArthur Airport Fire DepartmentLakeland Fire DepartmentLindenhurst Fire DepartmentManorville Community AmbulanceMastic Ambulance CompanyMastic Beach Ambulance CompanyMattituck Fire DepartmentMedford Volunteer Ambulance Inc.Melville Fire DepartmentMiddle Island Fire DepartmentMiller Place Fire DepartmentMontauk Fire DepartmentNesconset Fire DepartmentNissequogue Fire DepartmentNorth Amityville Fire CompanyNorth Babylon Fire CompanyNorth Lindenhurst Fire DepartmentNorth Patchogue Fire DepartmentNorthwell HealthNorthport Fire DepartmentOcean Beach Fire DepartmentOrient Fire DepartmentPatchogue Ambulance CompanyPlum Island Fire DepartmentPort Jefferson Volunteer AmbulanceRidge Fire DepartmentRiverhead Volunteer Ambulance CorpsRocky Point Fire DepartmentRonkonkoma Fire DepartmentSag Harbor Volunteer AmbulanceSaltaire Fire Company, Inc.Selden Fire DepartmentSetauket Fire DepartmentShirley Community AmbulanceSmithtown Fire DepartmentSound Beach Fire DepartmentSouth Country Ambulance, Inc.Southampton Village Volunteer AmbulanceSouthampton Volunteer AmbulanceSouthold Fire DepartmentSprings Fire DepartmentSt. James Fire DepartmentStony Brook Fire DepartmentStony Brook University HospitalStony Brook VACSuffolk County Police Dept.Terryville Fire DepartmentTown of Shelter Island EMSWading River Fire DepartmentWest Babylon Fire DepartmentWest Islip Fire DepartmentWesthampton War Memorial AmbulanceWyandanch-Wheatley Heights Amb.Yaphank Fire DepartmentPlease select your primary agency.Additional AgenciesAmagansett Fire DepartmentAmityville Fire DepartmentBabylon Fire DepartmentBayport Fire DepartmentBayshore Brightwaters Volunteer Rescue AmbulanceBohemia Fire DepartmentBrentwood Legion Ambulance ServiceBridgehampton Fire DepartmentBrookhaven National Labs Fire-RescueCenter Moriches Fire DistrictCentereach Fire DepartmentCenterport Fire DepartmentCentral Islip - Hauppauge Volunteer AmbulanceCold Spring Harbor Fire DepartmentCommack Volunteer AmbulanceCommunity Ambulance CompanyCopiague Fire DepartmentCoram Fire DepartmentCutchogue Fire DepartmentDeer Park Fire DepartmentDix Hills Fire DepartmentEast Brentwood Fire DepartmentEast Farmingdale Fire CompanyEast Hampton Village AmbulanceEast Islip Fire DepartmentEast Marion Fire DepartmentEast Moriches Community AmbulanceEast Northport Fire DepartmentEast Quogue Fire DepartmentEaton's Neck Fire DepartmentExchange Ambulance of the IslipsFair Harbor Fire DepartmentFarmingville Fire DepartmentFishers Island Fire DepartmentFlanders-Northampton AmbulanceGordon Heights Fire DepartmentGreat River Fire DepartmentGreenlawn Fire DepartmentGreenport Fire DepartmentHalesite Fire DepartmentHampton Bays Volunteer AmbulanceHauppauge Fire DepartmentHolbrook Fire DepartmentHoltsville Fire DepartmentHunter EMS - GMRHuntington Community First Aid SquadIslip Fire DepartmentIslip Terrace Fire DepartmentJamesport Fire DepartmentKings Park Fire DepartmentL.I. MacArthur Airport Fire DepartmentLakeland Fire DepartmentLindenhurst Fire DepartmentManorville Community AmbulanceMastic Ambulance CompanyMastic Beach Ambulance CompanyMattituck Fire DepartmentMedford Volunteer Ambulance Inc.Melville Fire DepartmentMiddle Island Fire DepartmentMiller Place Fire DepartmentMontauk Fire DepartmentNesconset Fire DepartmentNissequogue Fire DepartmentNorth Amityville Fire CompanyNorth Babylon Fire CompanyNorth Lindenhurst Fire DepartmentNorth Patchogue Fire DepartmentNorthwell HealthNorthport Fire DepartmentOcean Beach Fire DepartmentOrient Fire DepartmentPatchogue Ambulance CompanyPlum Island Fire DepartmentPort Jefferson Volunteer AmbulanceRidge Fire DepartmentRiverhead Volunteer Ambulance CorpsRocky Point Fire DepartmentRonkonkoma Fire DepartmentSag Harbor Volunteer AmbulanceSaltaire Fire Company, Inc.Selden Fire DepartmentSetauket Fire DepartmentShirley Community AmbulanceSmithtown Fire DepartmentSound Beach Fire DepartmentSouth Country Ambulance, Inc.Southampton Village Volunteer AmbulanceSouthampton Volunteer AmbulanceSouthold Fire DepartmentSprings Fire DepartmentSt. James Fire DepartmentStony Brook Fire DepartmentStony Brook University HospitalStony Brook VACSuffolk County Police Dept.Terryville Fire DepartmentTown of Shelter Island EMSWading River Fire DepartmentWest Babylon Fire DepartmentWest Islip Fire DepartmentWesthampton War Memorial AmbulanceWyandanch-Wheatley Heights Amb.Yaphank Fire DepartmentPlease select any additional agencies that you are associated with. Hold down the Ctrl key (Windows) or the Command key (Mac) to select more than one agency.