EMS Course Registration EMS Course Registration Please Note: After form submission, please expect a call from the CWCD to gather your payment information. CWCD accepts cash, money orders, purchase orders, and credit/debit cards.Personal InformationName* First Middle Last Email* Phone*AddressesMailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Physical Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Company Name* Select CoursesCourse Selection*Heartsaver Blood Borne Pathogens May 11, 2018 $65Heartsaver First Aid CPR AED May 12, 2018 $140Advanced Cardia Life Support for Experienced Providers May 26 – 27, 2018 $215Transition Course June 9, 2018 $235Pediatric Advanced Life Support June 23 – 24, 2018 $265BLS Healthcare Provider July 14, 2018 $135AHA ACLS Instructor July 21, 2018 $300AHA PALS Instructor July 21, 2018 $300Psychological Trauma in EMS Patients July 28 – 29, 2018 $110AHA BLS Instructor August 4, 2018 $225Heartsaver Blood Borne Pathogens August 10, 2018 $65Heartsaver First Aid CPR AED August 11, 2018 $140EMS Safety Course August 25 – 26, 2018 $110Transition Course September 8 – 2018 $235Principles of Ethics and Personal Leadership September 22 – 23, 2018 $160BLS Healthcare Provider October 13, 2018 $135Advanced geriatric and Core Geriatric Education for EMS October 27 – 28, 2018 $215Heartsaver Blood Borne Pathogens November 9, 2018 $65Heartsaver First Aid CPR AED November 10, 2018 $140Pediatric Emergency Assessment Recognition and Stabilization (PEARS) November 24 – 25, 2018 $255Transition Course December 8, 2018 $235Emergency Pediatric Care December 22 – 23, 2018 $215EMS Refresher - 30 hours (December 17-19)EMS Refresher - 40 hours (December 17-20)EMS Refresher - 50 hours (December 17-21)EMS Refresher - 60 hours (December 17-22)Please select the course you would like to register for.