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Purchase Order Class Registration

  1. Purchase Order Payment

    Please complete the below registration form if your organization will be paying for your classes

  2. Applicant Information

  3. For example, EMT Refresher Class, Initial EMT Training Class, etc

  4. For class cost, please refer to the Class information as advertised on our website

  5. Enter the dates of the classes you are attending

  6. EMT Initial Certification Orientation Class

    If registering for the EMT Initial Certification Class, please select which Orientation class you will attend.

  7. Enter Street Address, City, State, Zip Code

  8. Agency Contact email address

  9. Cancellation Policy

    All cancellations must be received at least 48 hours before the start of the class; class refunds are subject to a 25% deduction of the total fee paid. No refunds will be made for cancellations received after that time.

  10. Leave This Blank:

  11. This field is not part of the form submission.