Module 13: CPR- Cardiopulmonary Resuscitation

Name *

First

Last *

Last

Spouse/Partner Name If Attending

Email *

Phone Number *

Street Address *

City *

State *

Zip Code *

Choose your class *

Rocky Hill | April 26 | April 26 | 1 Wednesday | 6:00pm-9:00pm

Rocky Hill| April 29| April 29| 1 Saturday| 10:00am-1:00pm

I am an *

Name of Private Agency Licensed Home

This Module requires a prepayment of $45.00 per person in order to be registered.

Payment Methods *

Pay by Check Via Mail

Pay Now with Credit Card

To Pay By Credit Card:
PLease click Submit Registration and you will be brought to the payment page.

To Pay By Check:
Please fill in the registration form (all information is required) and mail along with your payment to:
CAFAF
Attn: Rochelle
2189 Silas Deane Highway, Suite 2
Rocky Hill, CT 06067

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