Thank you for Choosing EMTSS for your training.
Register For:
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B2102 (18Jan-27Feb 21)
B2103 (08 March-17 April)
B2104 (31 May-10 July)
B2105 (19 July-28 Aug)
B2106 906 Sep-16 Oct)
B2107 (25 Oct-04 Dec)
BR2101 (01-05 March WHK)
BR2102 (19-23 April ONDANGWA)
BR2103 (03-07 May WHK)
BR2104 (17-21 May SWK)
BR2105 (06-10 Dec SWK)
BR2106 (13-17 Dec WHK)
IN2101 (01 March - 02 July)
IN2102 (09 Aug-26 Nov)
Title
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Mr.
Mrs.
Ms.
Other
Initial(s)
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Surname
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First Name(s)
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ID Number
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Date of Birth
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Postal Address
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Physical address
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Email
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Contact Number
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What Region do you reside in?
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Highest School Certificate Received
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Grade 10 / Junior Secondary Certificate
Grade 12 / Senior Secondary Certificate
Points attained
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Terms & Conditions
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Compulsory when applying for the Emergency Care Practitioner BASIC – Course
Certified copy of school certificate must be attached.
Applicant must be 18 years or older.
Applicant must have a Grade 10 certificate
Compulsory when applying for the Emergency Care Practitioner INTERMEDIATE – Course
Must write an entry examination (60% Pass mark).
Original letter of completion on practical training. One year service (employment) as a registered ECP BASIC.
First Aid Certificate
First Aid Certificate
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Yes
No
Company obtained from?
Certificate number
Date
Employment Status
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Employed
Self-Employed
Unemployed
Student
Do you have any experience working of an Emergency Medical Service?
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Yes
No
At which training Institution did you complete your ECP Basic?
In which Country did you complete your ECP Basic?
Date from/to
Practical Training / Experience at Hospital / EMS
Department at Hospital / EMS
Position Held
Dates from/to
Important Things for EMTSS Facilitators to Know
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Knee Problems / Injuries
Back Problems / Injuries
Pregnant
Medical (E.g. epilepsy, Allergies)
Other / Family History
None
Please give more detail on your conditions
Please state conditions
Who to call in case of an emergency
Name & Surname
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Mobile
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Relationship
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Where did you hear about EMTSS?
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Attended Previously
Company
Email From EMTSS
Reffered to by Someone
Social Media
EMTSS Website
Word of Mouth
Other
The following documentation MUST be certified and attached to your application form (COMPULSORY): Applications without theses forms WILL NOT BE PROCESSED.
ECP – Basic:
Certified copy of Identification Document / Passport / Birth Certificate.
Certified copy of Grade 10 / Grade 12 certificate.
First Aid Class A certificate (current).
ECP – Intermediate:
Certified copy of Identification Document / Passport / Birth Certificate
Certified copy of Grade 10 / Grade 12 certificate.
Emergency Care Practitioner Basic Certificate (current).
Certified copy of HPCNA Registration Card (current).
Original letter of completion on practical training. One year service (employment) as a registered ECP Basic.
You may attach the files to this form or fax/email the information to us.
PLEASE TAKE NOTE OF THE FILE FORMATS THAT CAN BE UPLOADED: doc; xls; pdf; zip; jpeg; jpg
Upload ID Doc OR Passport
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no file selected
Upload grade 10 / 12 Certificate
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no file selected
Upload First Aid Certificate
no file selected
ECP Basic Certificate
no file selected
HPCNA Reg Card
no file selected
Letter of Completion
no file selected
Course Fees
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It is required that a deposit of 80% of the total course fees be paid within 30 days before starting date of course.
1.
Emergency Care Practitioner BASIC = N$ 7 950.00 (total cost – N$ 9 950.00)
No payment plan available – The amount needs to be settled before course commencing will be approved.
2.
Emergency Care Practitioner INTERMEDIATE = N$ 18 400.00 (total cost – N$ 23 500.00)
The Outstanding amount needs to be settled before course commencing will be allowed.
Payment Plan for ECP Intermediate?
Yes
No
Rewrites / Supplementary opportunities
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An applicant will pay a fee of N$ 500.00 per Not Yet Successful subject for the first (1st) rewrite attempt and N$ 1 500.00 for the second (2nd) and final rewrite attempt which will include all subjects (Successful and Not Yet Successful). Should you be found Not Yet Successful in any subject with the third (3rd) attempt, you are required to retake the course with the required financial implications in full.
Mark allocations for courses - Three (3) examinations consisting of a theory paper (Class test evaluations comprise 30% of the final result and the Final - ECP Basic and Mid-term ECP – It will count 70% towards total final result, with the overall pass mark of 50 % required on final result), practical OSCE (objective skills clinical evaluation) (pass mark of 75%) and practical simulation (scenario based) (pass mark of 50 %). The exams will be held over two (2) to three (3) days.
Cancelation Policy
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The following percentage will be deducted as an administrative fee on all cancellations prior to starting date of Course:
20% on 28 calendar days
50% on 21 calendar days
100% on 14 calendar days
Cancelation Terms and Conditions
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Cancellations must be submitted in writing to the Training Coordinator or training@emtss.com accompanied by the following to ensure refund;
Cancellation Letter signed by the Applicant
Bank Statement with Banking Details
Certified Copy of Identification Document
Refunds will be done within 7 to 10 working days
Refunds will be made by Electronically Transfer or Bank Deposit. No CASH Refunds.
PLEASE NOTE that a 3.5% Interest will be charged on all Cash Bank Deposits.
General Terms and Conditions
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Applicant will receive course material once payment is settled in full or on the first day of the course.
Applicant will not be allowed to attend any class if full payment is not received.
Applicant may wear comfortable but appropriate cloths – there will be practical simulations with bending and kneeling on the floor throughout the training.
Applicant must present his/her own stationery. (E.g. Pen, pencil, note book etc.)
Should a person not be able to bend, or work on the floor (disabled / medical condition), please inform the training coordinator on the application, to discuss probable solutions and opportunities?
No results/certificate will be provided if the account is not settled in full.
Interviews
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Applicants will be interviewed only once a month – As per scheduled dates
Applicants will also attend a fitness exercises – As per scheduled dates
ALL SECTIONS must please be completed BEFORE this application form will be approved and accepted by EMTSS.
Herewith I/we acknowledge that I understand the program requirements for which I have applied and that there will be a cancellation / withdrawal administrative fees involved. By submitting this application form I agree to all terms and conditions as detailed above.
I Acknowledge all T&Cs as stated above
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I Acknowledge T&Cs
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