St. John Ambulance - Kitchener-Waterloo

Please use this form to register for a class found in the training schedule. Registration is not complete until payment is received.

Course Name: *

Please give the course title. ex: Standard First Aid with CPR C

Course Date: *

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Year20092010

Your Name: *

Your Address: *

Please include your mailing address with postal code.

Your Phone Number: * ex: (555)555-5555

Your Email Address: *