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First Aid Registration

This document is a registration form for a Heartsaver First Aid course taking place on May 16th, 2012. It requests the participant's name, position, cell phone number and signature. It also specifies that non-employees of Moses Cone Health System should send a $60 check including the cost of the textbook, while employees should send a $10 check for just the textbook. The form notes that all registration charges are non-refundable and requires signature to confirm the participant will have the current Heartsaver First Aid manual before the course.

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aboy336
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38 views

First Aid Registration

This document is a registration form for a Heartsaver First Aid course taking place on May 16th, 2012. It requests the participant's name, position, cell phone number and signature. It also specifies that non-employees of Moses Cone Health System should send a $60 check including the cost of the textbook, while employees should send a $10 check for just the textbook. The form notes that all registration charges are non-refundable and requires signature to confirm the participant will have the current Heartsaver First Aid manual before the course.

Uploaded by

aboy336
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Please complete ALL the information below Mail form to: 1200 N.

Elm Street Attention: Lisa Dubili - Staff Education Greensboro, NC 27401

Heartsaver First Aid Course Registration Form


INCLUDE THE FOLLOWING: Non-employee of Moses Cone Health System - send check for $60 (includes cost of textbook) Employee of Moses Cone Health System - send check for $ 10 (cost of textbook)

Please Note: All registration charges will be non-refundable


Participant Name: Position: Mental Health Technician Participant Cell Phone #: Participant (SIGNATURE): ________________________________________________ Date of Course: May 16th, 2012 Current Heartsaver First Aid manual is required for this course. Signature required on registration form verifying that the participant has purchased and will receive the current manual before the course according to AHA guidelines. I confirm that I will have access to the current version of the Heartsaver First Aid manual. Signature: _____________________________ Date: __________________________

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