JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
CPR/AED Class Registration Form
Event Timing: 2022 Class dates: First Monday of each month dependent on instructor availability.
Event Address: Fortuna Volunteer Fire Department, 320 S. Fortuna Blvd., Fortuna, CA 95540
Contact us at (707) 725-5021 or
cglass@fortunafire.com
Sign in to Google
to save your progress.
Learn more
* Required
Email
*
Your email
Name
*
Your answer
Age
Under 12 (must be accompanied by an adult and be able to comprehend subject matter)
Over 12
Contact number.
*
Your answer
Organization (if applicable)
Your answer
What class are you registering for? (classes are held on the 1st Thursday of each month. Thursdays that fall on a holiday may be subject to change and it is advised to call for confirmation.)
*
MM
/
DD
/
YYYY
Previous CPR/AED training? (not required to attend)
*
Yes
No
Required
How would you like to pay? (an invoice will be sent to the email provided but payment may be made on the day of class)
*
Credit/Debit Card
Check
Cash
Required
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
