CPR Interest Form - United General District 304

Organization Name*

Contact Name*

First Last

Contact Email*

Phone

Estimated number of participants to be trained*

Due to COVID-19 considerations, there is a maximum of 5 participants in each class. If you have more than 5 people to be trained, we will work with you to determine the number of classes to be scheduled.

What days/times are convenient for your organization? (check all that apply)*

Weekdays from 4-6pm
Weekdays from 6-8pm
Weekends
I'd like to request a specific date
Other

What date(s) would you prefer?*

Other (please provide more info):*

Where would you like your training class(es) to be held?*

CPR training classes at our facility are held in the Wellness Center to the left of the main hospital entrance located at 2000 Hospital Dr., Sedro-Woolley.

Our facility on the Sedro-Woolley hospital campus
Your facility or other location

Location where the class(es) will be held:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

CPR, AED & First Aid Class Interest Form