Advancing the EMS profession

Agency Membership Sign-Up

NAEMT offers a very affordable and generous package of employee benefits to Agency Members. The cost for Agency Members is $400 for up to 10 members. A sliding scale for additional members above the first 10 begins at $35 per additional member. Complete the form below to begin your application to become an NAEMT Agency Member.

The online application accepts payment by credit card only. If you wish to pay by check, please contact NAEMT by email at or by phone at 1-800-346-2368 to request an invoice and begin your application process. The application must be completed by the Agency Representative/Contact only. Upon receipt, NAEMT will provide instructions on how to submit information for your individual Agency Members.

Agency Information
* Agency Name (Name of EMS Service)
* Agency Mailing Address:
* City
* Country
* State, Region or Province
* Postal Code
* Agency Website
* Agency Primary Contact Name
* Primary Contact Phone
* Primary Contact Email