Serving our nation’s EMS practitioners

Agency Membership Sign-Up

This application must be completed by the Agency Representative/Contact only. Upon receipt, NAEMT will provide your Agency ID number and 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