Membership Application
If you or someone you know is interested in joining our Association, please complete the information below and mail with your payment to:
Select Membership Status you Request:
___ $45 - Individual Combined NEMA + NAEMT
___ $15 - Individual NEMA only
___ $42 each - Squad Combined NEMA + NAEMT, first 20 members
___ $45 each - Squad Combined NEMA + NAEMT, member 21 through...
Membership is one year. Renewal notice will be sent at anniversary of membership
NEVADA EMERGENCY MEDICAL ASSOCIATION
P.O. BOX 538, CARLIN, NV 89822
Name_________________________________
Address_______________________________
______________________________________
City, State_______________________ ______
Zip___________________________________
Phone ________________________________
Fax __________________________________
Email________________________________
Service_______________________________
Nevada Certification Number______________
NREMT #______________________________