CPR Training

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CPR Training

Registration Form

Grady County Extension - Family and Consumer Sciences in collaboration with Grady County EMS

June 17, 2024

8:30 AM - 12:00 PM

Grady County Extension Office

65 11th Ave. NE

Cairo, GA 39828

Contact:

UGA Family and Consumer Science Extension Agent - Janette Burkes janette.burkes@uga.edu or 229-377-1312

Participants Name *

Participants Phone Number *

Personal Email - this will be where the certificate will be emailed *

Certification Type: *

Free - No Certification Test

$7 - Certification for certified Healthcare or Education Workers

$22 - Certification for all other work/school purposes

Will you require First Aid in addition to CPR? *

Yes

University of Georgia is an Equal Opportunity, Affirmative Action, Veteran, Disability Institution.

If you need a reasonable accommodation or language access services, contact the Grady County Extension office at 229-377-1312, at least three weeks prior to the program date.

Will you require special testing accommodations? *

Yes

If yes, specify accommodations:

Will you require test materials in a language other than English? *

Yes

If yes, specify language:

Demographic Information

By providing demographic information, you help ensure that our programs reach a diverse audience.

Race

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

More than one or another race

Clear selection

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Clear selection

Sex

Male

Female

Other

Prefer not to respond

Clear selection

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