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Emergency Medical Education

Emergency Medical Education

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Emergency Medical Education
Cohort 64 Repeat Application

Cohort 64 Repeat Application

Cohort 64 Paramedic REPEAT STUDENT Application

Application for repeat students admittance into the Palomar College Paramedic Program – Cohort 64 begins on August 26, 2024.

Last Name*
First Name*
Middle Initial*

Enter * if you do not have a middle name.
Phone Number (Main Contact)*
Email*
Mailing Address*
Should you be selected for the program, we would need a correct mailing address to send your acceptance paperwork.
Date of Birth*
Palomar College Student ID Number*
Have you ever applied to the this Academy before?*
- Yes
- No
Are you a High School graduate or a G.E.D. recipient?*
- Yes
- No
Name and location of High School or G.E.D. training site*
Schools attended other than high school (Name course of study and any degree(s) or certifications earned)*
Name additional training pertaining to Paramedic training; including military training. (Name course of study and any degree(s) or certifications earned.)
EMT-B certification (Check all that apply)*
- California State Certification
- San Diego County Certification
- Other California County Certification other than San Diego.
- National Registray Certification
- Other State EMT-B Certification
CPR Certification (Must contain AED component).*
- Healthcare Provider (American Heart Association)
- CPR for the Professional Rescuer (American Red Cross)
- Other (Must include AED certification)
Form of Identification*
- California State Driver’s License or ID card
- Other State Identification card or Driver’s license
Physical Conditions or Limitations – Do you have any physical limitations that would prevent you from performing tasks involved in the Paramedic Academy?*
EMT Work Experience*
List all Prehospital experience, hospital experience and volunteer experience. Please include locations
Have you ever been convicted of a felony or misdemeanor offense, including entering a plea of "No Contest", which resulted in you being imprisoned or , placed on probation?*
- Yes
- No
Emergency Contact – List name, relationship, address, day and night phone number*
Certification of Information – Completing this section verifies that all of the above information is correct to the best of your recollection. (Enter full name AND date)*
Class # that you start with?*

Please list the class # that you start with.
What part of the program did you fail out?*

List whether you failed in didactic, clinical, or field internship. If you failed in didactic, please list the block in which you were unsuccessful.

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Contact Information

Emergency Medical Education

Escondido Education Center

1951 E. Valley Parkway, Escondido, CA 92027

Sarah Desrochers

Associate Professor Paramedic Program Director Email: sdesimone@palomar.edu Phone: (760) 744-1150, ext. 8152

Skip Clark

Associate Professor EMT Program Director Email: wclark@palomar.edu Phone: (760) 744-1150, ext. 8153

Andy Page

Associate Professor Lead Paramedic Instructor Email: apage@palomar.edu Phone: (760) 744-1150, ext. 8158

Michael Finton

Professor EMT Instructor Email: mfinton@palomar.edu Phone: (760) 744-1150, ext. 8154

Patty Boyle

Associate Professor EMT/Paramedic Lab Coordinator Email: pboyle@palomar.edu Phone: (760) 744-1150, ext. 8139

Ally Do

Career Technical Program Specialist Email: ado@palomar.edu Phone: (760) 744-1150, ext. 8151

Kaylee Donaghy

Academic Department Assistant Email: kdonaghy1@palomar.edu Phone: (760) 744-1150, ext. 8186

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