Please complete this form in order to be considered for the ACEMS Emergency Medical Service of the Month. All applications will be reviewed and chosen by the Allegheny County EMS Manager and the Allegheny County EMS Council Chairperson. Please be sure to send 1-3 digital photos of the service (staff, vehicles, base site) to garyharvat@comcast.net Applications will on a rolling basis and you may submit at anytime for consideration. All applications will be kept on file for consideration each month. You need only submit your application one time in order to receive consideration. If chosen you will have the chance to update your application prior to publication on the web site. You will be notified if your service is chosen. Thank you.
Organization Name
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Name of Person Submitting
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Organization Address (street, city, zip)
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Business Phone
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Contact E-Mail Address
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Overview (3-4 Paragraphs)
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Awards Recognition Received
Total Active Members
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Service Area
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