CPR Class Registration

CPR/ACLS/PALS Class Registration

Fill out the form carefully for registration
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
CPR/ACLS/PALS Class Date / Type*
LOCATION:

SouthEast Regional EMS

2121 Century Drive

Clairton, PA 15025

(Please park in lower parking lot)

Information For CPR Classes

Time:

6:00 PM

Cost:

HeartSaver or BLS $50.00 / per person

** HeartSaver Pediatric First-Aid CPR/AED (PQAS approved) $65 / per person

Information for ACLS and PALS Classes

Time:

9:00 AM

Advanced Cardiac Life Support (ACLS)

Pediatric Advanced Life Support (PALS)

Cost: $75.00 / per person

ACLS Con-Ed Hours: 6.5 (Renewal)

PALS Con-Ed Hours 8.0 (Renewal)

SEREMS website (click here)
Notes / Requests:
Should be Empty: