Public Safety Pros of Connecticut, LLC Class Registration Form
Registration form for Public Safety Pros of Connecticut, LLC Classes
Full Name (if Single Student)
As you would like it to Apear on Your Card
Number, Street, City, State, Zip
if registering a group of two or more please list students below (as their names should appear on their cards)
if registering 8 or more students
Would you like to recive text alerts regarding classes? (i.e. Cancelations due to weather, etc)
Select the Class you are Registering for.
Heartsaver First Aid, CPR, & AED (AHA)
BLS for Healthcare Providers (AHA)
BLS online skills Practice and Evaluation (AHA)
First Aid (AHA)
Blood Borne Pathogens (AHA)
Emergency Medical Responder (ECSI)
Security Officer First Aid & CPR
Active Shooter Awarness
First Aid for Foster Parents
Family & Friends CPR (AHA)
Pet First Aid (ECSI)
Oxygen Administration (ECSI)
Emergency Oxygen (Medic First Aid)
Wilderness First Aid (ECSI)
Sports First Aid (ECSI)
AED Basics (PSPCT)
Enter the Date of the Class you are Registering for. (i.e. mm/dd/yyyy)
Class Start time
Where is the class being held?
Public Safety Pros of Connecticut, LLC - Wallingford
Public Safety Pros of Connecticut, LLC - Middletown
OfficePlace 515 CENTERPOINT DRIVE, MIDDLETOWN, CT 06457
Meriden Wallingford Chrysalis, INC - 14 West Main St. Meriden, CT.
Bristol Hospital EMS Training
My Home (See address at top)
Other(see info Below)
Class Location (Additional info)
Check(made payable to "Public Safety Pros of Connecticut, LLC")
Money Order(made payable to "Public Safety Pros of Connecticut, LLC")
Bill Me (Advanced Authorization Required)
Name on Credit Card
0000 0000 0000 0000
Code(usually on back of card)
Typed Name holds the same weight as my hand written signature, By entering my name below I give Public Safety Pros of Connecticut, LLC athority to charge the above credit card the full cost of tuition for the class selected above, I also realize that there is a additional 4% added for any aplicable Taxes/Processing fees. You will revice a recipt via email when your card is charged!
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