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
 

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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:
Skills Review and Testing

Date of Class:
(Student must contact the Administration office for the date you wish to attend)

* 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.
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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