If you wish to mail payment please print the registration form and return it to 341 Wyoming Ave. Suite 4 West Pittston, PA 18643 with payment. Make checks payable to CPST. (You must fill in the form after you click "Show a print version" at the bottom of this form.) ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- By submitting this form you are acknowledging that you have read CPST's policies and procedures found on the bottom of this page. The fields marked with (*) are required fields. * Name (as you wish it to appear on your card)  * required * E-mail Address  * required   Address * Course Healthcare Provider New Healthcare Provider Renewal Healthcare Provider Renewal On-line Key and Skills Healthcare Provider Renewal On-line Skills only Healthcare Provider Renewal Challange Healthcare Provider New online Key and Skills Healthcare Provider New online Skills only (Heartcode) Heartsaver Adult/Child CPR & AED Heartsaver Adult/Child , infant CPR & AED Heartsaver First Aid Pediatric First Aid Replacement Card BLS Healthcare Provider Replacement Card Heartsaver CPR Replacemnet Card Heartsaver First Aid Replacement Card ACLS Replacement Card PALS Instructor Course   Date and Time(please see course dates page for dates and times)   Phone * You must have a current 2010 guidelines book for all courses. Course price does not include a book. If you need a book you may purchase one for the price listed. Are you in need of a book? Yes No         Show a print version
Policies of Center for Public Safety Training Payment: All courses must be paid before day of class unless prior arrangements are made. Refunds: No refunds will be granted unless course is cancelled by CPST Class Cancellation: CPST will give 48 hr. notice for cancelled classes, except for inclement weather. Transfers: You may transfer once to another class with 24 hr notice. Replacement Cards: Replacement cards are available thru CPST for a Fee. Attendance: You are expected to arrive on time for each course. The instructor has the right to ask you to reschedule if you are late. Special Needs: Please notify us in advance if you have any special needs.	The American Heart Association strongly promotes knowledge and proficiency in BLS, ACLS, and PALS and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the American Heart Association, and any fees charged for such a course do not  represent income to the Association __________________________________________________________________________ The Center for Public Safety Training does not offer remediation options to on-line Healthcare Provider participants unless a previous Healthcare Provider Card is presented at skills session.