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REGISTRATION: EMT-Paramedic Refresher Program
 
 
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Please complete the following form to register for Educational Classes provided through the Conemaugh Learning Institute, Department of Continuing Education.

Do not use apostrophes (') in this form as it will cause an error.

Please note that this is not a secure website. All information you submit is given voluntarily and will only be used for services through Conemaugh Health System. Your information will NEVER be sold.

First Name:
Last Name:
Street Address:
Address 2:
City:
State:
Zip Code:
Phone Number:
Email Address:
Credentials:
   
Course Details  
Location:
Classes you wish to attend:
  

Fees:
All Modules = $80.00
Individual Modules = $20.00 each

Mail Registration Fee to:
Conemaugh Memorial Medical Center
Department of Continuing Education, GS 2037
1086 Franklin Street, Johnstown, PA 15905