American EMT
Education Foundation
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Scholarship application
Takes about 15–20 minutes. All sections support your eligibility — please be thorough.
Applicant Information
Full name *
Email address *
Phone number *
Date of birth
Street address *
City *
State / Province *
ZIP / Postal code *
Country *
Emergency contact (name, relationship, phone)
EMT Program Information
Desired EMT program location
Desired start date
Have you applied for admission?
Yes
No
Have you previously attended EMT training?
Yes
No
Employment Information
Current employer
Position
Length of employment
Full-time or part-time?
Full-time
Part-time
Not employed
Annual household income (optional)
Financial Need
Why are you seeking scholarship assistance?
Are you receiving any other educational assistance? If yes, describe.
Estimated amount of assistance requested ($)
Number of dependents supported
Personal Statement (Most Important)
Share your story — why are you pursuing EMS, and how will this scholarship help? (300–500 words)
Community Service
Volunteer experience
Community organizations
Public service experience
Military service (if applicable)
Background Questions
Have you ever been convicted of a crime that may affect EMS certification eligibility?
Yes
No
Do you possess a valid driver's license?
Yes
No
Are you physically able to perform EMT duties with reasonable accommodation?
Yes
No
I confirm the information above is true and accurate.
Submit application