Monthly Fire Testing Registration Form

Exam Registration
Candidate Information
Legal Name*
First Last
This must be the name that is in your Respond NH account
NELP or NH EMS License Number*
This number is found in your Respond NH Account. If you do not have a respond NH account Please create one here https://www.respondnh.org/lms/public/portal#/login
Exam Date Requesting*
MM slash DD slash YYYY

Second Tuesday of every month. (Bethlehem tests Quarterly on Wednesdays after Tuesdays Monthly Testing in Concord)
Time*
- 9:30 AM Arrival 9:15
- 6:30 PM Arrival 6:15
Course*
What area are you looking to test. Be as detailed as possible.
Practical or Written*
Location
- Concord
- Bethlehem (March,June,September,December ONLY)
Cellphone*
Email*

Please enter the email address associated with your Respond NH account.
Date of Birth*
MM slash DD slash YYYY
Testing Accommodations*
We must have a record of you needing accommodations. If we do not you will need to submit documentation to FSTEMS@dos.nh.gov
Testing Fees*
I agree. We will contact you to collect payment.
Testing Fee’s Price Written Exam: $30.00 Practical Exam (1 or 2 Stations): $30.00 Entire Practical: $75.00 Written & 1 or 2 Practical Stations: $60.00 Written & Full Practical: $105.00
PAYMENT MUST BE COLLECTED BEFORE THE EXAM
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Exam Registration