Registration: Maryland Fire & Rescue Institute

If you have already registered for access to our online scheduling system and you have already received your welcome email message with your temporary password, please sign in using that password. 

If you have not completed this form, thank you for taking a moment to complete and submit the following details.

Thank you for your patience, it might take a few hours or days until your registration has been processed.


* required field
APPLICANT INFORMATION
 

ADDITIONAL INFORMATION
* ACLS Instructor
 Yes  No
ACLS Instructor Certification Expiration Date
AHA Instructor #
NAEMT #
* AMLS Instructor
 Yes  No
AMLS Instructor Certification Expiration Date
* PHTLS Instructor
 Yes  No
PHTLS Instructor Expiration Date
302
 Yes  No
304
 Yes  No
* GEMS Instructor
 Yes  No
GEMS Instructor Certification Expiration Date
* NDLS
 Yes  No
* EPC Instructor
 Yes  No
EPC Instructor Expiration Date
MICRB Certification
 Yes  No
MICRB Expiration Date
BLS Certification Expiration Date
NRP #
MIEMSS #

Emergency Contact Information
Emergency Contact Name
Emergency Phone Number
Emergency Contact Notes



We appreciate your time and interest


 
 
College Park, Maryland 20742
(301) 226-9913
Shiftboard® is a registered Trademark of Shiftboard, Inc.
Privacy Policy   Mobile Site

Error

×

×
Loading....
Loading....
Loading....
Getting help ...