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Request CPR or Bleeding Control Class
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Contact Information for the Person Requesting
First Name
*
Last Name
*
Email
*
Phone
*
Class being requested
Hands-only CPR
GJFD Bleeding Control
Type of request
*
I'm requesting a class for just myself
I'm requesting a class for a group or organization
Group or organization details
The following information is only needed if you are requesting an event for a group or organization
Group/Organization Name
Number of people expected to attend
Class location
If you need GJFD to provide a training location, simply type "GJFD" for location.
A/V Equipment
-- Select One --
Yes
No
I'm not sure
Does your facility have access to a computer, projector, and screen?
Date and time Requests
Describe your availability for classes with dates and times, or days of the week and times as is appropriate to your group.
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