First*
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Last*
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Address*
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City*
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State*
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ZIP*
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Primary Phone*
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Secondary Phone
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email*
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| Class Details |
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Class*
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Please Select Your
Class Date(s)*
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Do you have a current CPR Card?
Note: You will be required to present a valid CPR card when class begins, or you will not be able to participate in the class. |
| Amount:
$
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| NOTE: A minimum deposit of $150.00 for the EMT Basic Class. $75.- for all other EMT classes. The full amount of $25.00 is required for all CPR Classes. Please see our refund policy on the Policies & Attendance page. |
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Special Requests or Needs
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| How Did You Hear About Us?
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| If you choose not to pay online, please call us to register and we will give you detailed instructions. No personal checks accepted. |
