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Personal information on this form is collected by the EMA Licensing Board under the
authority of the Freedom of Information and Protection of Privacy Act Section 26(c)
Emergency Health Services Act (section 6) and the Emergency Medical Assistant Regulation.
This information will be used to issue an EMA licence and maintain a permanent register of
licensed EMA's. If you have any questions about the collection of this information contact
our office at PO Box 9625 Stn Prov Govt, Victoria B.C., V8W 9P1, phone 250 952-1211. This
information is protected from unauthorized use and disclosure in accordance with the Freedom
of Information and Protection of Privacy Act and may be disclosed only in accordance with
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