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Name of Student EMS ID Number Name of Eligible Volunteer EMS Agency Student Address City County State Zip Course Sponsor Course Start Date Course Number Course Title The undersigned verifies that All of the information above is true and accurate. The EMT candidate listed above meets the following criteria a* Possession of valid CPR course completion documentation to the level of professional rescuer by a vendor approved by OEMS* b. Is a member in good standing of the Eligible Volunteer EMS Agen ...

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