Training Tracking Form

Search for:

Resources
Employment
- Active Recruitments – Emergency Response Specialist
- Active Recruitment – Internship
Newsletter
Contact Us

Date of Training *

PATC Training Coordinator (First and Last Name) *

PATC Instructor (First and Last Name) *

Number of Instructors *

Which MDERS PATC Training kit Number (#) did you use? Number located on the ends of the bag. Choose all that apply. *

Where did the training take place? *

What was the number of adult trainees? *

What was the number of juveniles (18 & younger) trainees? *

Instructor Comments/Feedback *

Please provide any comments/feedback you may have so we can enhance the training in the future.

Phone

Maryland ERS is a federally grant-funded program administered by the Maryland Institute for Emergency Medical Services Systems (MIEMSS).