Central New York Emergency Medical Services Regional Council, Inc. Jefferson Tower – Suite LL1 50 Presidential Plaza Syracuse, New York 13202 www.cnyems.org Phone: (315) 701-5707 (800) 295-2195 Fax: (315) 701-5709 CME EVALUATOR REFRESHER CLASS #14-09: CME EVALUATOR REFRESHER Date: December 2, 2014 Time: 17:00 – 19:00 Location: SAVES 77 Fennell Street Skaneateles, New York #14-11: CME EVALUATOR REFRESHER Date: December 8, 2014 Time: 17:30 – 19:30 Location: Joint Information Center 10 Airport Drive Fulton, New York #14-10: CME EVALUATOR REFRESHER Date: December 6, 2014 Time: 09:00 – 11:00 Location: Tompkins Cortland Community College 170 North Street Dryden, New York #14-12: CME EVALUATOR REFRESHER Date: December 10, 2014 Time: 17:30 – 19:30 Location: DeWitt Fire Department 4500 East Genesee Street DeWitt, New York Forms must be submitted to CNYEMS prior to class. Registration is required for attendance. REGISTRATION: (email or fax this form to CNYEMS prior to class) Date Course Name EMT # Level Street Address, City, State, ZIP Phone # Email Primary EMS Agency Secondary EMS Agencies Minimum Requirements for CME Evaluator Refresher Class: • No Active Sanctions by the NYS DOH BEMS. • No Regional Suspensions or Restrictions within the last year. Please include the following: 1. Copy of your current EMT/AEMT card
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