NEMSMA Leadership Education Provider
Application for Registration

Click Here For Application Instructions

Leadership Education Provider Information

Contact Information

Educational Delivery Model

Faculty Information

Organizational Background

Link to the OIG List


Signature & Attestation

The undersigned, authorized representative of this organization hereby attests to the following statements:

I have read our application for NEMSMA Leadership Education Provider Registration, and affirm that all statements made herein or in any document attached hereto are accurate, complete, true and correct in every aspect.

During the application process and upon and following accreditation, the organization will abide by and support the following:

-        The NEMSMA EMS Officer Competencies License;

-        The NEMSMA Registered Leadership Education Provider Eligibility Requirements;

-        Application Submission Portal Terms & Conditions of Use;

-        The NEMSMA standards for accreditation; and

-        The NEMSMA policies, procedures and practices

Following registration, the organization agrees it will notify NEMSMA in a timely manner of email and physical address changes, changes in organizational status, adverse actions by any state or federal agency or accreditation or licensure body, and that it will frequently check the NEMSMA website at to obtain any modifications to the items listed in the paragraph above.

Payment Information

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