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 BLS CPR Skills Check Only Heartsaver First Aid/CPR Heartsaver First Aid Only Heartsaver CPR Only Heartsaver CPR Skills Check Only Fire Report Other Notes
