Please complete Registration Below.
Please make sure your e-mail and phone number are correct.

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Secondary Email contact

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* 5. County of Residence

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* 6. State of Residence

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* 7. Phone Number

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* 8. Employer

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* 9. Your Primary Profession

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* 10. If your above response was Emergency Medical Technician or Paramedic - we must have your Letter and 6 digit State License Number    (example  P001882)

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* 11. Please select the course and time that you are interested in attending

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* 12. By registering for this class you are making a commitment to attend this class.  If you register and 'do not show' for the class or cancel within a week of the class - you may become ineligible to attend any Georgia Trauma Commission funded course for 1 year.

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