Registration Student Registration Student registration form. Name* First Last Email* Enter Email Confirm Email Password* 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* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Certification*CFREMT-BEMT-CCEMT-PPlease choose your level of certificationEMT No.* Please enter your EMT number.HiddenOLD EMT No Field (hidden)Please enter your EMT numberCertification Expiration* MM slash DD slash YYYY Please choose your certification expiration date.Primary Agency*Amagansett Fire DistrictBay Shore-Brightwaters Rescue Ambulance Co.Bayport Fire DepartmentBohemia Fire DepartmentBrentwood Legion AmbulanceBridgehampton Fire DistrictBrookhaven National Laboratory Fire DepartmentCenter Moriches Fire DistrictCentereach Fire DistrictCenterport Fire DistrictCentral Islip-Hauppauge Vol. Amb.Cherry Grove Fire DepartmentCold Spring Harbor Fire DistrictCommack Volunteer Ambulance CorpCommunity Ambulance CompanyCopiague Fire DistrictCoram Fire DistrictCutchogue Fire DistrictDeer Park Fire DistrictDix Hills Fire DistrictE. Moriches Comm. AmbulanceEast Brentwood Fire DistrictEast Farmingdale Fire Co., Inc.East Hampton Village AmbulanceEast Islip Fire DistrictEast Marion Fire DepartmentEast Northport Fire DistrictEast Quogue Fire DistrictEaton's Neck Fire DistrictExchange Ambulance of the IslipsFair Harbor Fire DepartmentFarmingville Fire DistrictFisher’s Island Fire DepartmentFlanders-Northampton AmbulanceGordon Heights Fire DistrictGreat River Fire DepartmentGreenlawn Fire DistrictHalesite Fire DepartmentHampton Bays Vol. AmbulanceHauppauge Fire DepartmentHolbrook Fire DistrictHoltsville Fire DistrictHuntington Comm. First Aid SquadInc Village of Amityville Fire DepartmentInc. Village of Babylon Fire DepartmentInc. Village of Lindenhurst Fire DepartmentInc. Village of Northport Fire DepartmentInc. Village of Ocean Beach Fire DepartmentInv. Village of Greenport Fire DepartmentIslip Fire DistrictJamesport Fire DepartmentKings Park Fire DistrictLakeland Fire DistrictManorville Community AmbulanceMastic Ambulance CompanyMastic Beach Ambulance CompanyMattituck Fire DistrictMedford Volunteer Ambulance Inc.Melville Fire DepartmentMiddle Island Fire DistrictMiller Place Fire DepartmentMontauk Fire DistrictNesconset Fire DistrictNissequogue Fire DepartmentNorth Amityville Vol. Fire CompanyNorth Babylon Vol. Fire CompanyNorth Lindenhurst Fire DepartmentNorth Patchogue Fire DistrictNorthport FDNorthwell HealthOcean Beach FDOrient FDPatchogue Ambulance CompanyPlum Island FD EMSPort Jefferson Vol. Amb. CompanyQuogue Village Police DepartmentRidge Fire DistrictRiverhead Vol. Amb. CorpsRocky Point Fire DistrictRonkonkoma Fire DistrictSag Harbor Volunteer AmbulanceSaltaire Vol. Fire CoSelden Fire DistrictSetauket Fire DistrictShirley Community AmbulanceSmithtown Fire DistrictSound Beach Fire DistrictSouth Country Ambulance, Inc.Southampton Village Police DepartmentSouthampton Village Vol. AmbulanceSouthampton Volunteer AmbulanceSouthold Fire DistrictSprings Fire DistrictSt. James Fire DistrictStony Brook Fire DistrictStony Brook University HospitalStony Brook Vol. Amb. CorpsSuffolk CountySuffolk County Police DepartmentSuffolk County Police Dept.Terryville Fire DistrictTown of Shelter Island Emergency Medical ServicesWading River Fire DistrictWest Babylon Fire DistrictWest Islip Fire DistrictWesthampton War Mem. AmbulanceWyandanch-Wheatley Heights Amb.Yaphank Fire DistrictPlease select your primary agency.Additional AgenciesN/AAmagansett Fire DistrictBay Shore-Brightwaters Rescue Ambulance Co.Brentwood Legion AmbulanceBridgehampton Fire DistrictCenter Moriches Fire DistrictCentereach Fire DistrictCenterport Fire DistrictCentral Islip-Hauppauge Vol. Amb.Cold Spring Harbor Fire DistrictCommack Volunteer Ambulance CorpCommunity Ambulance CompanyCopiague Fire DistrictCoram Fire DistrictCutchogue Fire DistrictDeer Park Fire DistrictDix Hills Fire DistrictE. Moriches Comm. AmbulanceEast Brentwood Fire DistrictEast Farmingdale Fire Co., Inc.East Hampton Village AmbulanceEast Islip Fire DistrictEast Northport Fire DistrictEast Quogue Fire DistrictEaton's Neck Fire DistrictExchange Ambulance of the IslipsFarmingville Fire DistrictFlanders-Northampton AmbulanceGordon Heights Fire DistrictGreenlawn Fire DistrictHampton Bays Vol. AmbulanceHolbrook Fire DistrictHoltsville Fire DistrictHuntington Comm. First Aid SquadInc Village of Amityville Fire DepartmentInc. Village of Babylon Fire DepartmentInc. Village of Lindenhurst Fire DepartmentInc. Village of Northport Fire DepartmentInc. Village of Ocean Beach Fire DepartmentInv. Village of Greenport Fire DepartmentIslip Fire DistrictKings Park Fire DistrictLakeland Fire DistrictManorville Community AmbulanceMastic Ambulance CompanyMastic Beach Ambulance CompanyMattituck Fire DistrictMedford Volunteer Ambulance Inc.Middle Island Fire DistrictMontauk Fire DistrictNesconset Fire DistrictNorth Amityville Vol. Fire CompanyNorth Babylon Vol. Fire CompanyNorth Lindenhurst Fire DepartmentNorth Patchogue Fire DistrictNorthwell HealthPatchogue Ambulance CompanyPlum Island FD EMSPort Jefferson Vol. Amb. CompanyRidge Fire DistrictRiverhead Vol. Amb. CorpsRocky Point Fire DistrictRonkonkoma Fire DistrictSaltaire Vol. Fire Co.Sag Harbor Volunteer AmbulanceSelden Fire DistrictSetauket Fire DistrictShirley Community AmbulanceSmithtown Fire DistrictSound Beach Fire DistrictSouth Country Ambulance, Inc.Southampton Village Vol. AmbulanceSouthampton Volunteer AmbulanceSouthold Fire DistrictSprings Fire DistrictSt. James Fire DistrictStony Brook Fire DistrictStony Brook University HospitalStony Brook Vol. Amb. CorpsSuffolk CountySuffolk County Police Dept.Terryville Fire DistrictTown of Shelter Island Emergency Medical ServicesWading River Fire DistrictWest Babylon Fire DistrictWest Islip Fire DistrictWesthampton War Mem. AmbulanceWyandanch-Wheatley Heights Amb.Yaphank Fire DistrictPlease 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.Enter Registration Code*