Paramedic Certificate Program Application Please note! A meeting with the Paramedic Program Director is required before submitting your application. If you have not yet met this requirement, your application will be denied. Please email josefski@gcc.mass.edu to schedule a virtual meeting. Applicants must also submit an Experience Verification Form along with this online application. Application Deadline: August 20, 2023 "*" indicates required fields Are you currently an EMT or AEMT?*You must answer yes in order to be considered for the program. Yes No Name* First Last Preferred name Email* Enter Email Confirm Email Phone*Address* Street Address Address Line 2 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 GCC Student ID #* Program LocationThe PMC Program is offered in two different locations. Every effort will be made to place you into your first choice location. Greenfield Community College • Tue/Thur evenings, plus scheduled Saturdays Northampton, Industrial Drive • Mon/Wed evenings, plus scheduled Saturdays Requirement #1 • College Application*Program application and transcripts (if applicable) will not be reviewed until you have submitted a GCC application. If you are already enrolled at GCC it is highly recommended to choose Liberal Arts/Health Science with Paramedic Intent for your major. To change your major, complete and submit a Change of Major Form to the Registrar. I have completed a GCC Application for Admission Requirement #2 • Grade Point Average*If you have previously attended GCC, a cumulative GPA of 2.0 or higher is required at the time of application and program entry. I have a cumulative GPA of at least 2.0 at GCC I have never taken classes at GCC Requirement #3a • English Placement Testing or Equivalent College Coursework** After your transcripts have been reviewed an email will be sent to your GCC student email address indicating whether or not placement testing is required. If testing is required visit gcc.mass.edu/testing to schedule an appointment. I have completed GCC placement testing in English placing into college-level English, OR received a grade of C- or better in ENG 090 and ENG 094, OR provided a college transcript* to the Office of Admission which shows that equivalent coursework has been completed Requirement #3b • Math Placement Testing or Equivalent College Coursework** After your transcripts have been reviewed an email will be sent to your GCC student email address indicating whether or not placement testing is required. If testing is required visit gcc.mass.edu/testing to schedule an appointment. I have completed GCC placement testing in math within five years placing out of developmental math, OR received a grade of C- in MAT 090, OR provided a college transcript* to the Office of Admission which shows that equivalent coursework has been completed within 5 years. Requirement #4 • Meeting with Paramedic Program Director*Applicants are required to meet with the Paramedic Program Director prior to submitting an application. Email josefski@gcc.mass.edu to schedule a 2-hour appointment. Placement testing must be completed before your appointment. Depending on availability, it may be possible to take placement tests and meet with the Program Director on the same day. I have met with the Paramedic Program Director Date of Meeting* MM slash DD slash YYYY Requirement #5 • Experience Verification Form*Download and print the Paramedic Experience Verification Form to be completed and signed by an ambulance service director or other authorized supervisor who can verify your EMT status and patient contact hours. I have submitted my Experience Verification Form Hiddenroute to dawn