Registration Module 13: CPR- Cardiopulmonary Resuscitation Please register for our training event by filling in the form below Name * First Last * Last Spouse/Partner Name If Attending Email * Phone Number * Street Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Choose your class * Rocky Hill | April 17 | April 17 | 1 Monday | 10:00am-1:00pmRocky Hill | April 17 | April 17 | 1 Monday | 10:00am-1:00pm 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 * Private Agency Licensed Home (please provide name) DCF Licensed Foster Home DCF Licensed Pre-Adoptive Home DCF Relative Care Home DCF Special Study Home DCF Authorized Respite Home Adoptive Family Home DCF Staff Member Other Independent Licensed 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:CAFAFAttn: Rochelle2189 Silas Deane Highway, Suite 2Rocky Hill, CT 06067 reCAPTCHA If you are human, leave this field blank. Click the button to print the registration form. Print this page