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Enter to win a free seat in our upcoming May EMT class, or a seat in one of our EMT refresher classes (your choice)! Just complete this survey and click "SUBMIT" at the bottom of the form, and you will be entered in the drawing! Winners will be notified 1 week before class begins. This data will not be shared with any other organization and is for Know How use only.

Your name: (required)
Your address:
Your City:
Your State: ZIP:
Your email: (required)
Contact phone:

Your gender: (required)

Your age: (required)

Is this your first visit to our site? (required)

How did you first learn about Know How?

Have you taken a class with us before? No Yes
If so, when?

Why did you come to our site?

What kind of classes are you interested in? (check all that apply)
CPR First Aid EMT-First Responder EMT-Basic Paramedic Critical Care Paramedic ACLS/PALS/BTLS

Would you be interested in on-line EMT-Basic Refresher or Paramedic CME?
If so, what format would you prefer?
What would be your second choice?
How would you prefer to pay for such a service?

What supplemental kind of classes would you be interested in taking? (check all that apply)
BTLS ATLS PHTLS AMLS The Difficult Airway Course Defensive Driving Course CCEMT-P Critical Care Endorsement Course

Which of the following media do you read/view at least once a week?
    Courier-Journal
    The Record newspaper
    The Southeast Outlook newspaper
    Velocity newspaper
    Velocity website
    radio station
    Kentucky EMS Connection website
    Thrifty Nickel newspaper
    Other newspaper
    Other EMS website

What is your highest level of active certification?

What is your current employment?

Would you like to be added to our upcoming classes e-mail list? No Yes

What would you prefer to win ?