California Institute of Emergency Medical TrainingCalifornia Institute of Emergency Medical Training
California Institute of Emergency Medical Training California Institute of Emergency Medical Training California Institute of Emergency Medical Training
 

**This page is secured**

REGISTRATION REQUIREMENT:
1. Read and accept the terms of enrollment.
2. Fill in all areas with an "*".
Download Enrollment Agreement
Full Page Print Version.


(check here)
I understand and accept the terms in this enrollment agreement. I further understand that this is an eccelerated course and that it is an ambitious undertaking that I am fully prepared to accept.

Type of Class:
EMT-Basic Course

Date of Class:
8/6/2010

* First Name:

* Last Name:

Middle Name:

* Email Address:



Street Address:

City/Zip:

State:


* Phone (day):

Phone (night):

* 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*

          



 
 
  © 2009 CIEMT.com, All rights reserved. (562) 989-1520