Complete Safety Resources Inc.

Employer / Company Name *
Employer / Company Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name of Applicant 1 * First Last
Name of Applicant 2 First Last
Name of Applicant 3 First Last
Name of Contact Person * First Last
Email Address of Contact Person *
Phone Number of Contact Person * ### - ### - ####
Workshop Selection

Please select one of the following workshop dates.
Standard First Aid & CPR - $135 plus HST
Emergency First Aid & CPR - $75 plus HST
Comments or Special Requests
Billing Information
Billing information same as above
Name First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number ### - ### - ####
Please Select Your Method of Payment

Once your registration is processed our office will send an invoice. If you prefer to pay via credit card, someone from our office will contact you to collect the payment details. We do not collect credit card information online.
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