Name
Address
City
State
Zipe Code
Employer: (select one)
Nursing Hhome/ Assisted Living
Day Care
Public School
Personal Certification
I Wish To Enroll In: (select one)
CPR/ AED For Professional Rescuer - $55.00
First Aid/ CPR - $50.00
Blended Course First Aide/ CPR/ AED - $75.00
Course Dates: (select one)
July 7, 2018 0900-1400
July 10, 2018 0900-1400
August 4, 2018 09600-1400
August 7, 2018 0900-1400
Phone
Certification:
By Checking this box I certify the information presented is correct to the best of my knowledge and I agree to attend the course indicated. NO REFUNDS FOR NO ATTENDANCE.
American Red Cross CPR for Professional Rescuer
To sign-up for one of these courses just download the form, completed the form as required and FAX the completed for to the number shown.
Be sure to go to Online Payment to pay for your course.
