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46th Annual Nebraska Statewide EMS Conference

Attendee Registration

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Your Information

First name Last name Email Phone Agency / Employer

License & Certification

License level --------- EMR EMT AEMT Paramedic Other State license number NREMT number (if applicable) EMS ID (if known)

Registration

Registration type --------- Test ($250.00) How will you pay? Pay Upon Arrival Pay Now (Credit Card) Department Paying Check (Mailing) Share my contact info with conference vendors (optional) Register