Pre-REGISTRATION FORM : EMT CLASSES NIGHTTIME 6-10PM
August 31 thru Dec 21 2010

THIS IS A PRE-REGISTRATION ONLY. A COMPLETED APPLICATION WITH A DEPOSIT IS NECESSARY TO HOLD A PLACE FOR YOU IN THE CLASS

NIGHT CLASS RUNS TUES AND THURSDAY  NIGHTS  6-10PM...

Name:
    Date of Birth:
E-mail Address:


Contact Phone number:  

Street address:  City:Zipcode:

Social Security- last 4 digits:  

Comments or questions:

 

This is an initial class not a recert. Tuition is $550 with all books included. If you would like to reserve a program T-Shirt please note the size in the comment area. T-shirts are $15.  Books are available in advance.
A deposit is necessary to hold your registration.  When you press SUBMIT this form will be sent and a printable form will come up to be sent in with your deposit. All tuition must be paid by CASH or MONEY ORDER or BANK CHECK only. PERSONAL CHECKS ARE NOT ACCEPTED.GARAGE PARKING IS AVAILABLE AT AN ADDITIONAL CHARGE. IF INTERESTED PLEASE INDICATE IN THE COMMENTS SECTION.

 

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