Kenai Peninsula College

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General Information

Please provide the following information.

First Namerequired

Last Namerequired

Middle Initial

UA Student ID (if applicable)

EMT Levelrequired

Years of EMT Experiencerequired

Healthcare Provider CPR Expiration Daterequired

Contact Information

Please provide your contact information.

Home Phone

Mobile Phone

Emergency Contact First Name required

Emergency Contact Last Namerequired

Emergency Contact Phonerequired

Mailing Address

Please provide your mailing address.

Street Address Line 1required

Mailing Address Line 2

City required

State/Province/Regionrequired

Countryrequired

Physical Address

Please provide your physical address.

Physical Street Address Line 1

Physical Street Address Line 2

City

State/ Province/ Region

Postal/Zip Code

Country

High School Record

Please provide information about your high school record.

Did you graduate?

Yesno

College Record

Please provide information about your college record.

College Name

College City

Years Completed

Degree Received

GPA

Major

Did you graduate?

YesNo

Supplemental Documents

Please email the following document to Paul Perry at peperry@alaska.edu

Resume
Three Personal References
Three Letters of Recommendation
500-700 word essay on "Why do you want to be a Paramedic"
State of Alaska EMT Card (EMT1, EMT2, EMT3, or Adv. EMT)
National Registry EMT or ADV. EMT Card (if applicable)
American Heart Association BLS-Healthcare Provider CPR Card
Copy of DD-214 showing "Honorable Discharge" if applicable
Interested Party Report (State Background Check)

Paramedic Online Application