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Timber Mesa Fire and Medical District
EMS World Expo Contest Entry
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Name
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First
Last
Phone Number
Email Address
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Current State of Residence
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Email Currently or
EMS Licensure
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Not Licensed
EMT-Basic
AEMT
EMT - Paramedic
Fire Certifications (Please select all that Apply)
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Not Currently Certified
Not Certified but Attending Classes
Haz Mat
Firefighter I
Firefighter II
Fire Inspector I
Currently Employed in Fire or EMS Service?
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Yes
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Questions or Comments
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