Axon Education | New Application

Take the Next Step in Your Career

Ready to apply to EMS School? Complete the application below. You can also give us a call at (325) 218-4444 to talk to a real person today.

Want more information about Texas EMS School’s programs? Fill out our Request for Information Form and we’ll get in touch as soon as possible.

Applicant Information

Disclaimer: We only accept applications from individuals who are current residents of the state of Texas. Others will not be considered.

First Name*

Please enter a first name.

Middle Name

Please enter a middle name.

Last Name*

Please enter a last name.

Email*

You must add email

Phone*

This field is required.

Is this a mobile phone?*

Yes

This field is required.

Address*

Please enter a address.

City*

Please enter a city.

State*

This field is required.

ZIP CODE*

Please enter a postal code.

Date of Birth*

Please enter a valid date of birth.

Gender

This field is required.

Are You a US Citizen or Permanent Resident?*

This field is required.

I do not have a Social Security Number.

Driver License Number*

Please enter a driver license number.

I do not have a driver license.

Driver License State*

Please enter a driver license state.

Are You a Current or Former Member of the United States Military?*

This field is required.

Emergency Contact Name*

Please enter a emergency contact name.

Emergency Contact Phone*

Emergency Contact Relationship*

Please enter a emergency contact relationship.

Will you be utilizing scholarship or grant funding from an outside organization?

Yes

This field is required.

Program & Career Goals

Disclaimer: Need your EMTB for the PAR, PARBR, and AEMT programs.

Program*

This field is required.

When Would You Like to Start the Program?*

This field is required.

Who Will Be Responsible for the Cost of Your Education?*

This field is required.

What is the name of the organization that will be responsible for the cost of your education?*

This field is required.

Does Your Employer or Organization Have a Training Agreement with Axon?*

This field is required.

NREMT License Number

Please enter a NREMT license number.

I do not have a NREMT license number.

State of Licensure*

This field is required.

If you are licensed in multiple states, use your primary state license number. If you are licensed in Texas, use your Texas license number.

I do not have a state license number.

State License Number

Please enter a state license number.

Why Do You Want to Complete This Program?*

This field is required.

What Is the Highest Level of Education You Have Completed?*

This field is required.

Have You Previously Completed An Entirely Online Course for Credit?*

This field is required.

Work Experience

Current Employer*

Please enter a current employer.

Enter "Unemployed" if not currently employed.

Job Title*

Please enter a job title.

Enter "Unemployed" if not currently employed.

How Many Years of Full-Time Work Experience Do You Have?*

This field is required.

Do You Have Experience Working in Healthcare or as a First Responder?*

This field is required.

Previous Healthcare Experience

Have You Ever Held Healthcare Credentials or Any Type of Healthcare License?*

This field is required.

Signature

By submitting this application, I hereby certify that:

1) The information included in this application is true and correct.

2) I understand that Axon Education LLC will conduct a background check based upon the information included in this application that will be used for admission purposes.

3) I agree to receive phone calls, text messages, and/or email communications from Axon Education LLC, at the phone number(s) I have provided, including a wireless number, regarding furthering my education. I understand and agree that these communications may be generated using an automated technology.

I agree to the Application Terms.*

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Take the Next Step in Your Career

Applicant Information

Program & Career Goals

Work Experience

Previous Healthcare Experience

Signature

Congratulations!