Instructor Registration

DT4EMS is currently updating their records moving forward in 2016 with regionalization of our training centers to better support you. Please check the map prior to registering and have your current instructor certificate available for upload in pdf or jpg form. Your regional center will be contacting you soon!

Instructor Update Registration

Instructor Name *Enter First & Last Name
Agency Affiliation *Who do you work/teach EVE Courses for?
Address *
This is where you want DT4EMS Corporate correspondence mailed to.Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Instructor Level *Please select one of the following.
Date *Current Expiration Date
Email *Enter the best contact email
Phone *Enter best contact number (preferably cell phone)
URL Web address that your courses are offered at if any. Example http://www.yourwebsite.com
File Upload *Upload a current copy of your instructor certificate
Region Affiliation *
Please select which region you live in based on the map provided in the instructor alignment page.Region 1 - MHECRegion 2 - Reedsburg

Verification

Please enter any two digitsExample: 12
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