CPR 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".

3. Mail form & payment to:
     NIEC
     P.O. BOX 11176
     Philadelphia, PA 19136
IMPORTANT: Please see the descriptions of each course on the CPR page to be sure
that you are registering for the correct course.

CPR for General Public $35.00 with book (approx. 2-3 hours)
 

Please select a date:

  


HeartSaver CPR (Adult and/or pediatric)

$75.00 with book or $55.00 without book

Please choose a date:
   

Health Care Provider (approx. 4-5 hours for full course, 3 hours for recert)

  Fees are:      $110.00 including book and pocket mask
                      $100.00 with book only                                      (Circle One)
                     
$95.00 with pocket mask only
                      $85.00 if neither book or pocket mask is needed
                     (The pocket mask is required. You may bring your own with you).

 Please choose a date:
   

Name:

Address:

City: State:   Zip:

Phone (Day):   Evening:

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