Welcome to

First Aid & Safety Training

First Aid & CPR

REGISTRATION FORM

ALL COURSES ARE BOOKED ON A FIRST-COME FIRST-SERVED BASIS. We accept payments via Cash, Visa, and MasterCard or check/money order payable to First Aid & Safety Training. If you wish to register for this class, we prefer pre-registration and pre-payment five (5) days ahead of the course date.

If you wish to register, please fill out the following form for each person who will be attending.

Date of class (MM/DD/YY): Month

Name of Student (Last Name, First Name MI):

Mailing Address: Unit/Apt: City: , State Zip:

Home Phone Number: Office Phone Number:

Email Address:

Method of Payment: CASH CHECK VISA/MC

Card # Expire Date(MM/YY):

CANCELLATION POLICY IN EFFECT:

Unless cancellation notification is received one week in advance of course date, full registration will be charged. Once registered, a cancellation fee of $5.00 will be charged. If the student received a workbook it must be returned in good condition and unmarked prior to receiving the refund. If the workbook is damaged the cost of the workbook plus taxes will be held back from the refund amount.

or you may FAX or mail Registration form, with all information completed.

FAX number (509) 452-1501