Schedule a CPR Class
All certifications are provided through ASHI (American Safety and Health Institute). Once submitted, please allow up to 72 hours for a phone call to confirm.
Name (first and last)
Day Time Phone Number
Must be in ###-###-#### format
Preferred Start Time (All dates/times subject to instructor availability)
Level of Certification
Professional CPR (Healthcare Provider)
CPR & AED (Community)
Type of Certification
Number of Students
IFD Co. #1; (Kroger Plaza) 1980 Delaware Crossing, Independence, KY 41051
IFD Co. #2; (Taylor Mill Road) 740 Cox Road, Independence, KY 41051
IFD Co. #3; (Turkeyfoot Road) 4118 Richardson Road, Independence, KY 41051
Never submit passwords through Google Forms.
This form was created inside of Independence Fire District.