The state certification/licensure ID number assigned to the crew member. Name of Personnel. Last Name of Personnel. First name of Personnel. Middle name or Initial of Personnel. Street or PO Box of the personnel's mailing address. Street or PO Box of the personnel's mailing address. City of personnel's mailing address. State of personnel's mailing address. ZIP code of personnel's mailing address. Work Phone of the Personnel. Home phone of the Personnel. Primary email address of the Personnel. The EMS Personnel's Date of Birth. The EMS Personnel's gender. The EMS Personnel's race as defined by the OMB (US Office of Management and Budget). The EMS Personnel's ethnicity as defined by the OMB (US Office of Management and Budget). The Personnel's State EMS Certification level. The Personnel's State EMS Certification level. Indication of National Registry Credential for the level of Certification/Licensure in D78. The Current certification date of the personnel's current certification. Initial certification date of personnel's current State certification. The personnel's total length of EMS service at any level. The personnel's total length of EMS service at any level. The end date service was based on.