Paramedic - Application for Entry This application is to be submitted by the deadline posted on the webpage. Directions: Read this application carefully as you are responsible for knowing and understanding the content. This form is to be completed and submitted electronically. This application must be completely filled out to be considered for entry or re-entry in the Paramedic Program. Communication from the paramedic program to the candidate will occur through the student’s campus email address.Application InformationPlease select the semester which you are applying:FallSpringPlease select the year which you are applying:202420252026Student Status:(Required) A new Paramedic program applicant (no paramedic classes taken) A student requesting re-entry into core paramedic courses (within last two years). (Please see the Catalog for re-entry requirements.) Transfer student (have taken paramedic courses at another institution) If you are not certain, please contact the Paramedic Program Office at 575-624-7076Transfer Student Information: All students seeking transfer from another paramedic program, must submit a letter of good standing from the program in which you previously attended.Re-entry Information: List all paramedic course failures and/or withdrawals below:Year AttemptedName and Number of CourseSchool AttemptedWithdraw (W) or Failure (F) Add RemoveAdd as many rows as needed by clicking the plus (+) symbol to the right of the row. What was your Academic Standing at the time and the circumstances surrounding your paramedic course withdrawal(s) and/or failure(s)?What actions have you taken to improve your academic success should you enter/re-enter this paramedic program? Have the circumstances noted above changed or been resolved?Requirements ChecklistRequired Information - Checklist ALL Official High School (or GED/HiSET) Transcripts ALL Official College Transcripts ALL EMS Education Transcripts Regular Application for Admission to ENMU-Roswell Current New Mexico EMT-Intermediate License Current American Heart Association BLS for Healthcare Provider Certification MUST be in Good Academic Standing with ENMU-Roswell It is the Student's Responsibility to see that all of the information required for entry is on file with the Office of Admissions & Records by the Paramedic application deadline.Student InformationName(Required) First Middle Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email(Required) Student ID Date of Birth(Required) Home Phone NumberCell Phone Number(Required)Work Phone NumberPlace of Employment Hours worked per weekDo you have a current unencumbered EMT License? Yes No EMT License Information Name on License State License Number Expiration Date Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Emergency Contact(Required) Name & RelationshipEmergency Contact Phone Number(Required)AttachmentsAttach any relevant files here: Drop files here or Select files Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 50 MB. More than one form can be submitted at a time.Student SignatureStudent Signature(Required)Date MM slash DD slash YYYY IF YOU ARE CONSIDERING THE PARAMEDIC PROGRAM, PLEASE CAREFULLY READ THE FOLLOWING INFORMATION: Read the ENMU-Roswell Catalog. Students enter or reenter the Paramedic Courses under the Catalog in effect at the time of entry or re-entry to the program. Contact a Health Education Advisor in the Student Services Center for preadmission paramedic program advising. Submit applications for admission into the University if you are not currently a student Applications are valid for a limited time. It is the student’s responsibility to make sure all applications are current at the time of the selection process. Submit an application to the Paramedic Program. Paramedic applications are valid for only the semester and year indicated on the application. It is the student’s responsibility to have official high school transcripts (or GED Certificate), all college transcripts and/or all prior EMS education transcripts in the Admissions Office by the required date. Transfer credit is awarded only by the Registrar. Students must be in good academic and financial standing with the University. Enrollment in the Paramedic Courses is limited. Students not approved to progress into the paramedic courses must submit a new application if seeking entry into the paramedic program. During the paramedic program core courses, students may be required to attend clinical experiences requiring travel outside of Roswell. The New Mexico EMS Act provides for possible denial of licensure to persons convicted of a felony or who are in violation of the Parental Responsibility Act. All students will have a nationwide FBI background check completed within the first two weeks of the fall semester. Any student with a felony conviction within the past seven years or a misdemeanor conviction involving alcohol, illegal drugs, or family violence within three years should make an appointment with the nursing program director prior to submitting the final application. All students approved for entry into Health Education Unit core courses at ENMU-R are required to undergo drug screening. Drug screening will occur prior to attending any off-campus clinical experience and may be repeated randomly. Students may be asked bring a current drug prescription and labeled medication container. EMS is a physically demanding career in which the practitioner may be exposed to a variety of illnesses. Proof of health status tests/immunizations is required prior to registration into paramedic courses. The student will be given direction on submitting required documents to the paramedic program with the acceptance letter. Proof of current American Heart Association Basic Life Support for Healthcare Providers certification is required by clinical agencies is the responsibility of the student. Red Cross certification is not accepted. Eastern New Mexico University is an affirmative action and equal opportunity employer. The University does not discriminate on the basis of race, color, national origin, sex, or handicap in its programs, activities or employment. Persons seeking additional information about the University’s nondiscrimination policy should contact the Director of Affirmative Action, ENMU-Roswell, P.O. Box 6000, Roswell, NM 88202-6000. It is the candidates’ responsibility to complete a Paramedic Entrance Exam within one year of the application deadline. You may register by contacting the EMS Program Director at 575-624-7235. • Candidates may test on the ENMU-R campus or other approved sites. There is a charge for the test.