Type of Class:
EMT-Basic Course
Date of Class:
11/19/2010
* First Name:
* Last Name:
Middle Name:
* Email Address:
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Street Address:
City/Zip:
State:
* Phone (day):
Phone (night):
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* Payment Method:
PayPal
(Accepts Credit Card or Check)
Paypal account NOT required. If you pay with PayPal the FULL AMOUNT of the Course will be calculated in the check out.
Deposits may be paid with paypal only if you have your own Paypal account. All payments must indicate the name of the student and the Course start date.
Will mail out a check
(checks that are mailed do not ensure registration until it is received.)
*$30 unpaid check fee*
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