Basic Life Support/Heartsaver Instructor Renewal Course 2018 Registration Fees and Course Dates Fees: $75.00 Time: 1:00-4:00 Dates: □ □ □ □ □ January 12 12 June 28 September 18 December 18 □ □ □ □ □ February 27 April 25 July 18 September 28 December 21 □ □ □ □ 16 May 9 August 9 October 31 □ □ □ □ 28 June 8 August 31 November 9 Name Address City State Zipcode Employing Agency Phone Email Method of Payment □ Check Payable to UnityPoint Health-DM CTC (must accompany registration) – □ Visa □ Mastercard Credit Card # Expiration Date 3-Digit Verification Code Cardholder Name (as it appears on card) Cancellation Policy The registration fee, minus $25 is refundable up to 5 working days prior to the program. After that time, no refund is available. UnityPoint Health Moines reserves the to cancel the program due to insufficient enrollment. If this occurs, participant’s –Des registration fee will be refunded. Courses cancelled due to adverse weather conditions will be rescheduled. Participants will be granted a refund if there is a conflict with the new date.
Basic Life Support/Heartsaver Instructor Renewal Course 2018 Registration Fees and Course Dates Fees: $75.00 Time: 1:00-4:00 Dates: □ January 12 □ 12 □ June 28 □ September 18 □ December 18 □ February 27 □ April 25 □ July 18 □ September 28 □ December 21 □ 16 □ May 9 □ August 9 □ October 31 □ 28 □ June 8 □ August 31 □ November 9 Name Address City State Zipcode Employing Agency Phone Email Method of Payment □ Check – Payable to UnityPoint Health-DM CTC (must accompany registration) □ Visa □ Mastercard Credit Card # Expiration Date 3-Digit Verification Code Cardholder Name (as it appears on card) Cancellation Policy The registration fee, minus $25 is refundable up to 5 working days prior to the program. After that time, no refund is available. UnityPoint Health –Des Moines reserves the to cancel the program due to insufficient enrollment. If this occurs, participant’s registration fee will be refunded. Courses cancelled due to adverse weather conditions will be rescheduled. Participants will be granted a refund if there is a conflict with the new date.
HS%20Instructor%20Renewal%20-%20kd.docx