Evaluation Worksheet for Certificate Emergency Medical Technician (EMT-1) Refresher
 
SID: ________________________________ Skills Certificate - 5019
  Effective: Fall 2009
  Public Safety
Name: ________________________________ (707) 836-2907

REQUIREMENTS: Complete 0.5 units

Emergency Medical Technician (EMT-1) Refresher Course Requirements - complete 0.5 units
CourseDescriptionUnitsCompletedIn ProgressComments
EMC 104.1 Emergency Medical Technician Refresher0.5   


    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

Comments


 

Date: ________________________   By: ____________________________________________