PALS 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
 
FULL PALS COURSE  $280.00 with textbook - $235.00 no textbook

Please select a date:

 

RECERTIFICATION PALS COURSE  $235.00 with textbook - $185.00 no textbook

Please select a date:
 


Name:

Address:

City: State:   Zip:

Phone (Day):   Evening:

Select one:  Physician  Nurse   Paramedic   Other:

**Cancellations if submitted at least 2 weeks prior to course will be accepted less $50.00 administrative fee.
+ Send copy of current PALS card if registering for re-certification course.  


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