Registration for a first aid training

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PLEASE COMPLETE THIS FORM FOR ANY REGISTRATION PAID BY INTERAC (bank transfer), by credit card (Visa or MasterCard) or cash in class. For any BILLING TO AN ORGANIZATION request, PLEASE SEND AN EMAIL (info@atoutplus.com) indicating the first name, last name, phone number and date of birth of the person to register, and specify the billing details. Course details will be sent by email within 2 working days. Please send an email at info@atoutplus.com if you do not receive that email or for any changes or questions.

Course title *

Date the course begins

YYYY

Participant's first name *

Participant's last name *

Participant's email address (personal email only - will be used as the file ID) - IMPORTANT: for any HOTMAIL ou OUTLOOK address, please send us an email at info@atoutplus.com to make sure you receive the course details email from us. *

Participant's phone number (ideally your cellphone to be able to reach you the morning of the course if necessary) *

Participant's date of birth *

YYYY

For INTERAC PAYMENT: have the transfer made to info@atoutplus.com and use "plus" as answer to the security question. Please indicate (here) the name of the account holder making the payment:

For payment by VISA or MASTERCARD: please call at 514-253-4481 during normal office hours. Cash is also accepted in class. *

I understand

Required

IMPORTANT: registration is done automatically when this completed form is sent. Please send an email to info@atoutplus.com for any changes or questions. *

I understand

Required

IMPORTANT: if you do NOT receive an EMAIL from us within 2 WORKING DAYS or for any HOTMAIL or OUTLOOK address, please send an email to info@atoutplus.com to ensure you receive the course details.

I understand

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