Request a CPR Class

2. First Name*
3. Last Name*
5. Phone Number*
6. Email Address*
8. Address*
10. City*
11. State*
12. Zip Code*
16. Orgenaization Requesting the Class*
18. Type of CPR Class*
    -- Select One --Heartsaver CPR/AED - 4 hoursHeartsaver First Aid/CPR/AED - 8 hoursBLS Provider (Healthcare professionals only) - 4 hours
20. Is this an initial or refresher course?*
    -- Select One --InitialRefresher
22. Preferred CPR Class Date/Time*
24. Additional Comments
26. Notice

    Please allow 3-5 business days for RBFD to reach out to schedule your CPR class request. Scheduling is based on availability of crews, training schedules, and other department activities. 

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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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