LSC - North Harris EMT - Basic Program Application

First Name *

Last Name *

Lone Star College ID Number:

If you do not have a Lone Star College Student ID Number, STOP HERE and DO NOT save your form. Go to the ApplyTexas page:www.applytexas.org and create an account. You will need to verify your email to continue and you will be prompted to sign back into ApplyTexas. Set up your account profile.

If you have any questions, please consult with Student Services at (281) 618-5412 before completing the application. *

Address *

Address 2

City *

State/Province *

Zip/Postal Code *

Phone *

Lone Star Email Address * 🛈

Social Security Number *

Date of Birth * +

Please select a preferred semester and location. *

Spring 2025, North Harris Campus (Day)

Summer 2025, North Harris Campus (Day)

Fall 2025, North Harris Campus (Day)

Spring 2026, North Harris Campus (Day)

Terms and Conditions *

You consent to receive communications from us electronically. We will communicate with you by e-mail or phone. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

Criminal History, Medical Document Manager and Drug Screen *

I understand I must complete a criminal background check, drug screen, and upload shot records to a medical document manager. This must be completed prior to registration approval.

Lone Star College Academic & Registration Holds *

I understand that if I have Holds, or tasks in my To Do List for my Lone Star College account, that I can not be registered for the EMT Basic class. I understand that I must have these completed and taken care of prior to being registered.

Please sign *

clear