Apply to become an EMS Instructor/Coordinator

To complete the application:

• Your MA EMT number
• Documentation of experience as an EMT providing prehospital care with a licensed ambulance service
  • We need a signature of a licensed ambulance service representative. This should be either the service director or their designee.
• Accredited training institution (ATI) sponsorship/affiliation
  • You must complete an internship at a Department-accredited EMS training institution (ATI).
  • We need the signature of the Program Director on the application indicating sponsorship.
     

Application attachments

• State EMT card: A copy of both sides of your current Massachusetts EMT certification card (at any level)
• BLS CPR instructor card: A copy of both sides of your current Basic Life Support (BLS) Instructor credentials provided by a nationally recognized organization. BLS credentials must reflect current cardiopulmonary resuscitation (CPR) and emergency cardiac care resuscitation science and treatment recommendations issued by the International Liaison Committee on Resuscitation (ILCOR)’s and Emergency Cardiovascular Care Science with treatment Recommendations (CoSTR), or successor body.
• Instructor/Training (I/C) course completion: A copy of a course completion certificate from a Department approved I/C training course.
  
  There are 2 separate master instructors approved to conduct the I/C training course. Please contact the instructor to ask about their next scheduled I/C training course.
  • Mark Forgues
    email: markforgues@verizon.net
  • Greg West
    email: instructorwest@gmail.com
• Resume: A copy of your current resume which identifies at a minimum:
  • Education
  • Employment
  • Educator/instructor experience/background

• Personal statement: A typed personal statement of at least 1000 words. Explain why you wish to become a Massachusetts EMS Instructor/Coordinator. Include what you will contribute to the initial EMT education field.
• NAEMSE (optional): Proof of course completion from the National Association of EMS Educators (NAEMSE) Level 1 course, if applicable. Completion of this course is substantially equivalent to the Massachusetts I/C training course.

Optional attachments: Background

If you answer “yes” to any of the questions in the Background section, attach a written explanation with supporting documentation, as explained on the application.

You must have written approval from the Department before beginning your I/C internship. We will not accept internship hours attained prior to the date of the Department’s approval letter to begin the internship.

Instructor/Coordinator and/or Examiner renewal

If you hold Instructor/Coordinator, Examiner (any level), and/or Chief Examiner (any level), you must submit a renewal application for each. The Instructor/Coordinator and/or Examiner renewal applications and required supporting documentation may be submitted starting in the fall. The deadline is January 31, prior to expiration. No applications or documentation will be accepted after the deadline.