Registration

Centre Communities Chapter
Community Health & Safety Course Registration

Paid pre-registration for all community courses is required. To register for any community course, please complete the form below and return it to the Chapter at the address at the bottom of the page. If you have any questions please call our office at (814) 237-3162 Monday-Friday from 9 a.m. to 5 p.m. (Please print)

Name: __________________________________________________________

Address: ________________________________________________________

City: __________________________________ State: ____________ ZIP: ______

Email:_________________________________

Day Phone: _______________________ Evening Phone: _____________________

Course Name: _______________________ Course Fee Enclosed: $_________

Class dates: First Choice: ___________________Second Choice: ________________

Please note: We can not refund your course fee. If you would like to transfer into a different class, please call at least a day before the class date. Only two transfers is permitted.

This Web site is not secure. Until the Chapter gets a secured site, the form below may only be used for mail and walk-in registrations.

Card Type: VISA □ AmEx □ MasterCard □ Card Number: _____ _____ _____ _____

Expiration Date: ____ / ____ ID Number: ______ (Last three digits in the signature block on the back of the card)

Signature: _________________________________________

Please send registration form and payment to:
American Red Cross
Centre Communities Chapter
Suite 203, Health & Safety
205 E. Beaver Avenue,
State College, PA 16801

Click here to return to the Health & Safety page.