Mutual Aid Ambulance EMS - P.O. Box 350, Greensburg, PA. 15601

Course Registration

Name     Address City    

State     Zip Home Phone Work Phone  Cell/Pager

E-Mail     Organization/Affiliate

Current Level of Certification Public Firefighter Doctor First Responder EMT Paramedic RN PHRN

Name of Course:     Date of Course:

Location of Course:     Time:

Initial Course: Yes No                Renewal: Yes No

The American Heart Association requires a text for all AHA courses. Textbooks may be purchased and available for pick up at Mutual Aid Ambulance Service, 561 West Otterman St, Greensburg, PA. 15601

Any questions regarding registration may be directed to: sfick@mutual-aid.com, or by phoning: 724-837-6134 ext 108.