Payment FormUse this form to enter payments for miscellaneous fees and classes at the direction of PFR staff. Amount (required) $ Contact Information First Name (required) Last Name (required) Associated Organization Email Address (required) Phone Number (required) Street Address (required) City (required) State (required) Zip Code (required) Class or Service - please choose one (required)BLS CPR [$85] BLS CPR Skills Check Only [$45] Heartsaver First Aid/CPR/AED [$65] Heartsaver First Aid Only [$50] Heartsaver First Aid Skills Only [$45] Heartsaver CPR/AED Only [$50] Heartsaver CPR Skills Check Only [$45] Fire Report [$25 minimum] Other Notes
