Become A Member

If you’d like to become a member of our organization, please submit the form below or you can download and email us our application at the bottom of this page.

Our membership is currently 101 active EMT’s strong and we operate 24 hours a day, 7 days a week, 365 days a year.

Date of Birth

Residence Address

Primary EMS District (select one)

JordanQuaker HillGoshenOswegatchieCohanzie

Next of Kin/ Emergency Contact