Name

First Name

Last Name

Email Address

Institution

Phone

(###)

###

####

Select

Select the course you would like to take.

Date

Enter date of desired class

YYYY

Have you taken a class with us before?

Yes

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Comments

Pleas let us know if you have any other questions/concerns regarding your registration.

Thank you for submitting your request to reserve a seat in an upcoming CPR class. We will be contacting you shortly to confirm your reservation and to provide the specific details for your class.

If you have any questions, please don’t hesitate to send us an email: chris@sunshinecpr.com or text 208-841-4553 and we will respond as soon as possible.