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Course Application
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Atendee Information
Company (If you are registering on behalf of a Company please fill out the Company Name below, if not fill in None) *
Title *
Miss.
Mr.
Mrs.
Firstname *
Lastname *
ID Number (Sedula) (If unavailable fill in your birth year, birth month, birth day and 00 e.g. 1984102600)) *
Id Type *
ID Card (Sedula)
Birth Date (YYYY-MM-DD) *
Contact Information
Email *
Street Name *
Street Number *
Mobile Number *
Home Number
Work Number
Course Information
Course *
AHA BLS HcP (Price XCG: --, Price USD: --, Duration: 4 Hours)
AHA Heartsavers FA- CPR & AED (Price XCG: --, Price USD: --, Duration: 5 Hours)
AHA Heartsavers CPR & AED (Price XCG: --, Price USD: --, Duration: 5 Hours)
AHA BLS HcP Instructor (Price XCG: --, Price USD: --, Duration: 6 Hours)
AHA ACLS Provider (Price XCG: --, Price USD: --, Duration: 8 Hours)
AHA ACLS Instructor (Price XCG: --, Price USD: --, Duration: 6 Hours)
AHA PALS Provider (Price XCG: --, Price USD: --, Duration: 8 Hours)
AHA PALS Instructor (Price XCG: --, Price USD: --, Duration: 6 Hours)
AHA PEARS Provider (Price XCG: --, Price USD: --, Duration: 6 Hours)
AHA Family & Friends (Price XCG: --, Price USD: --, Duration: 2 Hours)
AHA Heartsavers BLS Instructor (Price XCG: --, Price USD: --, Duration: 6 Hours)
AHA ACLS EP Instructor (Price XCG: --, Price USD: --, Duration: 6 Hours)
AHA PEARS Instructor (Price XCG: --, Price USD: --, Duration: 6 Hours)
Information Session (Price XCG: 0, Price USD: 0, Duration: 2 Hours)
CHF Hands on Only Training (Price XCG: --, Price USD: --, Duration: 1 Hour)
HeartCode® BLS (Price XCG: --, Price USD: --, Duration: 4)
CHF Basic Life Support Provider (Price XCG: --, Price USD: --, Duration: 5 Hours)
CHF Hands On Only (Price XCG: --, Price USD: --, Duration: 1 Hours)
Notes
Extra information
All courses include certification, food & beverages for the duration of the course. They are provided by full instructors of the International Training Center of the Curacao Heart Foundation. As soon as you sign up we will contact you with all details regarding the location and exact date of the course you selected.
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