RESCUE TRAINING INC - EMS Refresher

Please fill in your information below to enroll in the January 25-29, 2021 NREMT Recertification Course

Thank you!

Question Title

* 1. What is your first name?

Question Title

* 2. What is your last name?

Question Title

* 3. What is your phone number?

Question Title

* 4. What is your mailing address?

Question Title

* 5. What is your e-mail address?

Question Title

* 6. What is your EMS certification level?

MFR

EMT

AEMT

Paramedic

Question Title

* 7. NR Certification Number

Question Title

* 8. NR Expiration Date

Date

Date

Question Title

* 9. CPR Expiration Date

Date

Date

Question Title

* 10. ACLS Expiration date

Date

Date

Question Title

* 11. Please choose program for registration:

EMT 30-hours ($175)

AEMT 40-hours ($200)

Paramedic 48-hours ($250)

Question Title

* 12. Please choose additional offering

BLS / CPR Recert ($25)

ACLS Recert ($75)