Registration Form - EMT Course Spring 2021


Note: No refunds will be made after the class has been in session 16 hours. Any Continuing Education class may be canceled due to low enrollment.

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Note: Red * text indicates required fields

Note: If you have a valid CedarNet account, you may login now to fill in demographic information.

First Name, Last Name *
Address Line 1 *
Address Line 2
City, State, Postal Code *
Country
Phone Number *
Cell Phone Number
Email Address *
*
How did you hear about the EMT course? (check all that apply)   
  
  
  
  

Class Information

Please select the class for which you are registering:
*
Please remember to also complete and send the EMT Course Application and check the web site for what to do after applying. Medical paperwork is due the first day of class.

Payment Information

Total Amount: $