By choosing to register for this conference, I am confirming that I am active in the first responder community.
My involvement is in one or more of the following roles: A student currently enrolled in a relevant course of study, An employee contributing to an organization, A volunteer dedicating time and effort to an organization, and/or A member of the military serving our nation.

By clicking “Register,” I acknowledge this connection and confirm the truth of the above statements.

Please fill out the information below, then click Next to continue.

Home Address

INSTRUCTIONS: The state license or certification number are required to receive CEU's.

However, if you DO NOT have a State License or Certificate Number please enter "N/A" for the State License or Certificate Number
and for the expiration date please enter "January 1, 1900".

* Are you Nationally Registered?This question is required.
* 

1.14 Privacy Acknowledgement

I understand that [name of CE provider] will submit a record of my course completions to the CAPCE AMS as a requirement of CAPCE accreditation. I further understand that my course completion records may be accessed by or shared with regulators such as state EMS offices, training officers, and NREMT on a password-protected need-to-know basis. In addition, I understand that I may review my record of CAPCE-accredited course completions by contacting CAPCE.