Idaho Center of Emergency Medical Training

Heart Saver Registration

First Name:

Last Name:

Street Address:

Apartment Number:

City:

State:
Zip:

Phone Number:

E-Mail:

Course(s):
  All classes include book
HS - Pediatric First Aid/CPR $70.00
HS - Adult First Aid/CPR $70.00
HS - CPR Adult/Child/Infant + AED $40.00
HS - CPR en Español $35.00
HS - First Aid en Español $35.00
Total Cost:
(Full Payment Required)
Find a class in our schedule then enter the date you want to attend below.
Course Date:
(MM/DD/YY)
Name on Card:

Type of Card:
Card Number:

CSC:

Expiration Date:
(MM/YY)
I understand that my credit card will be charged the amount above
upon receipt of registration form.
Please Initial:



©2011 Idaho Center of Emergency Medical Training. All rights reserved. 1018 W. Sanetta St. Nampa, ID 83651