Please Print Out and complete the form below and send with your payment by check or money order only to:
Solutions for Occupational Safety
607 E. Emma St.
Lafayette CO 80026
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SOS CLASS REGISTRATION FORM
Name: ______________________ Phone: __________
Address: _____________________________________________
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Email: _______________________________________
CLASS:
Basic Life Support - Healthcare Providers (BLS) $49__
BLS Skills Checkoff $49 __________
Heartsaver CPR and AED $49 ________
Heartsaver First Aid $49 ___________
Heartsaver Pediatric First Aid $98 _________
Family and Friends First Aid for Children $49 _______
CLASS LOCATION and TIME
Date: __________________ Time:_______________
Location: _________________________________________
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Notes
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SOS: 805-708-4226 Patti@sosinco.com