Evaluation Worksheet for Certificate Emergency Medical Technician (EMT-Basic)
SID: ________________________________ Skills Certificate - 5018
  Effective: Spring 2014
  Public Safety
Name: ________________________________ (707) 836-2921

REQUIREMENTS: Complete 7.5 units

Emergency Medical Technician (EMT-Basic) Prerequisite - complete 2.0 units
CourseDescriptionUnitsCompletedIn ProgressComments
EMC 100 Emergency Medical Responder2.0   
Emergency Medical Technician (EMT-Basic) Requirements - complete 5.5 units
CourseDescriptionUnitsCompletedIn ProgressComments
EMC 103 Emergency Medical Technician Basic5.5   

It is important that students who are completing an Associate Degree and desire to transfer to a four-year institution meet with a counselor to plan their lower division coursework. While many majors at SRJC are intended to align with lower division major preparation required by California public universities, specific lower-division major requirements vary among individual campuses. See a counselor, visit the Transfer Center, and check Guides For Transfer in Specific Majors, and ASSIST to review transfer preparation guides for specific schools and majors.


A current certification in CPR for the Health Provider is required prior to beginning the program.
Emergency room experience (8 hours) and ambulance experience (16 hours) are a required component of EMC 103. Prior arrangements for this experience will be made as part of class curriculum. Students will also be required to attend assigned weekend activities as scheduled.

    Evaluation worksheet completed upon receipt of Transfer Credit Evaluation form. Includes credit from other institutions only received to date.

    Evaluation worksheet completed for ________________________________. Includes all SRJC and transfer credit received to date.

Units completed:    __________
Units in progress:    __________
Total:    __________
    Requirements Completed
    Pending (work in progress)
    Requirements Not Completed



Date: ________________________   By: ____________________________________________