Prospective Internship / Observer Form.  

Please complete the form if you are interested in internship for your EMT courses through American Medical Response. General requests for observational rides are limited to Fire agency personnel only, and are taken on a case by case basis.  

Your Name:

Telephone Number:

Your Email Address:

     School / Agency:

       Internship Level:

Requested Month / Dates of internship.

Please contact me by: Email Telephone