City College of San Francisco Paramedic Program Application
Fall 2026 Cohort
Personal Information
First Name
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Last Name
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Email
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example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
CCSF ID #: This is the student ID number for your CCSF account and should being with a W, C, or @ symbol. If you do not have a CCSF ID, please apply for one at www.ccsf.edu. All applicants must have a CCSF ID number.
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Date of Birth
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Month
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Day
Year
Date
Have you applied to the CCSF Paramedic Program in the past 2 years?
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Yes
No
Did you complete your EMT training through City College of San Francisco? (EMT 100 at the John Adams Campus or CityEMT program)
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Yes
No
Are you a military veteran of the United States Armed Services?
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Yes
No
Have you ever been convicted of a drug or alcohol offense, sexual misconduct, a DUI or felony crime? (Note: The California Health & Safety code may prohibit licensure for applicants convicted of certain crimes.)
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Yes
No
California Driver's license number
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California EMT certification number
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NREMT number (note: you are not required to maintain NREMT certification in California. This information is for verification only)
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Employment Information
Name of employer
Address of employer
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of employer
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Supervisor
Email address of Supervisor
Date you started employment
-
Month
-
Day
Year
Date
Describe your responsibilities with this employer
Are you still employed with this agency?
Yes
No
Name of employer #2
Address of employer #2
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of employer #2
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Supervisor
Email address of Supervisor
Date you started employment
-
Month
-
Day
Year
Date
Describe your responsibilities with this employer
Are you still employed with this agency?
Yes
No
Please list and describe any other paid experience related to emergency medical service.
Volunteer experience: Name of volunteer organization
Description of responsibilities
Name of supervisor
First Name
Last Name
Email address of supervisor
example@example.com
Name of volunteer organization #2
Description of responsibilities
Name of supervisor
First Name
Last Name
Email address of supervisor
example@example.com
Other volunteer experience: If you have other volunteer experience that you would like to include, please describe it in the space below:
Education Experience
PREREQUISITES: Please check if you have completed (or are in progress with) the following prerequisite course: (include unofficial transcript in the attachments to this application showing grade or "in progress")
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BIOL 106 at CCSF completed, or
BIOL 106 at CCSF in progress, or
College level anatomy and physiology with lab taken at a college other than CCSF completed, or
College level anatomy and physiology with lab IN PROGRESS at a college other than CCSF
Healthcare provider level CPR current certification (AHA BLS healthcare provider)
Other healthcare related college coursework completed (include unofficial transcript)
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EMT 104: Preparation for Paramedic (formerly known as Advanced Skills for EMS Providers) taken at CCSF or in progress
ECG Interpretation
Pharmacology
Public Health coursework (ex. community health, nutrition, epidemiology)
Other
If you answered "other", please describe below and provide evidence in an unofficial transcript.
Other current medical licenses or certifications
Registered Nurse or Physician Assistant (challenge applicant)
Respiratory Therapist
LPN/LVN/CNA
Community Health Worker (CHW)
AEMT
ACLS certification
PHTLS certification
PALS or PEPP certification
Other
If you answered "other", please describe below and provide evidence in an unofficial transcript and/or copy of license or certification.
File Upload: Please attach a copy of your unofficial transcript(s) verifying your completion of prerequisites (include even if in progress) and the additional coursework. For veterans, please also request your military transcript (Joint Services Transcript or JST). If you need assistance in finding your JST, please contact cpl@ccsf.edu.
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File Upload: Please attach a copy of your current California Driver's license, CPR certification, NREMT and/or California EMT card, and other licenses/certifications (if any) verifying the above information.
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References
References
Please provide the names and emails for TWO individuals who will complete a reference survey on behalf of you as an applicant for the CCSF Paramedic Program. The individual referenced will be automatically sent the link to the survey. Please do not attach reference letters to this application. All references will go through the survey link.
Name of reference #1
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First Name
Last Name
Email of reference #1
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example@example.com
Name of reference #2
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First Name
Last Name
Email of reference #2
*
example@example.com
Personal Statements
Please tell us what led you to seek a career in EMS and why you are applying to the program at City College of San Francisco.
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The City College of San Francisco Paramedic Program requires regular weekly attendance on campus, active participation in lab and simulations, attendance and engagement in clinical and field rotations, and completion of a capstone field internship. Describe how you will handle the challenges of balancing work, personal life, and school and optimize your commitment to your paramedic education.
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Verification of Application
Verification of Application
By signing below you are verifying that you are the applicant and attest to the information included in this application as yours and yours alone. Any evidence as to the validity of information or that others contributed to the submission of information in this application is grounds for immediate disqualification.
Name of Applicant
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First Name
Last Name
Signature applicant
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