Wauconda Fire District CPR Class Registration Form

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CPR CLASS DATES:

January 14, 2010       CPR for Adult, Child, and Infant with AED for Adult and Child

February 11, 2010      CPR for Adult, Child, and Infant with AED for Adult and Child

March 11, 2010          CPR for Adult, Child, and Infant with AED for Adult and Child

April 8, 2010              Healthcare Provider CPR

May 13, 2010             CPR for Adult, Child, and Infant with AED for Adult and Child

June 10, 2010            CPR for Adult, Child, and Infant with AED for Adult and Child

August 12, 2010         Healthcare Provider CPR

September 9, 2010     CPR for Adult, Child, and Infant with AED for Adult and Child

October 14, 2010        CPR for Adult, Child, and Infant with AED for Adult and Child

November 11, 2010     Healthcare Provider CPR

 

All boxes below are required.

 

Full Name:
Address:
Phone:
E-Mail Address:
Confirm E-mail:
Date of Class:
Do you live in the Wauconda Fire District?	Yes />    No />
Questions/Comments:
Authentication Code: (type the characters you see in the image)	Press F5 (reload this page) if you    can't read the characters.