Virtual Instructor Led Training CAPCE Accredited F5 Individual Class Registration and Payment
After submitting this form, a payment link will appear in the registration confirmation box. Click the payment link. In Paypal you can pay as a guest with a credit card, or pay from your Paypal account (if you have one). Choose the classes for which you signed up, or choose pay for all, and click "pay now". Following payment, your information will be saved and you will be sent a link for each class. Please save that email to join the class at the date and time listed. Following the F5 classes you will be sent via email, a link to a short course evaluation survey. Once the course evaluations are received, an email will be generated with your completion certificate. It is your responsibility to attend the class and complete the associated post course survey. If you can not attend the course you signed up for, you may be able to change classes or attend another scheduled instance of the same class.
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Email *
First Name *
Last Name *
State of Certification *
Certification Number in that state *
Expiration date in that state *
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City of Residence *
State of Residence *
Certification Level *
NREMT Number (if applicable). If not applicable, leave blank
Next NREMT recertification date (if applicable). If not applicable, leave blank
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