BCLS
Instructor Registration - Register in 3 easy steps
1.
Select
the
date
that
you
would
like
to
attend
and
complete
the
form
below.
2.
Print
this
page,
enclose
payment
to
"NIEC"
and
any
prerequisites
listed
on
course
description
page.
3.
Mail
form,
payment
and
prerequisites to:
NIEC
P.O. BOX 11176
Philadelphia, PA 19136
Name:
Address:
City: State: Zip:
Phone (Day):
Evening:
Select one: Physician
Nurse Paramedic EMT Other:
**Cancellations if submitted at least 2 weeks prior to course will be
accepted less $50.00 administrative fee.
+ Send copy of current BCLS card if registering for re-certification
course.