Class Title           

Date and Time           

Price            

P.O. # or Authorized Name           

Company Name / If Individual Just List Name           

Address           

Address Line 2           

City           

State           

Zip Code           

Telephone           

Fax           

E-mail Address           

Name of Attendee           

Name of Second Attendee           

Name of Third Attendee           

Name of Forth Attendee           

Comments           

Enter Class Title and Class Date to Confirm        

Registration Policy For CPR and First Aid Courses: Due to the limited number of seats available in these classes we do require pre-registration. Your seat is not reserved until we have received the course fee. Enrollments are accepted by phone, U.S. Mail, or email. We accept cash, checks, money order, VISA & Master Card Credit Cards (We DO NOT accept DEBIT cards at this time). If the class is full at the time of your registration you will be notified.

Cancellation Policy For CPR and First Aid Courses: Payments are Non-refundable. Cancellations must be received a minimum of 72 hours (3 full working days) prior to scheduled class time in order to reschedule.

Registration Policy For All Other Open Enrollment Courses: Payment of course fee is REQUIRED before beginning of class.

Thank you for your registration. You will be invoiced for this class registration.

Your information will not be sold or distributed.