Registration Form

Fundamentals of Search and Rescue
FUNSAR 2007

$200.00 per individual
Due two weeks in advance of the class.

Please print this form, fill it out, and include it with your payment

Name: _____________________________  Agency:_________________________

Address 1:___________________________________________________________

Address 2: ___________________________________________________________

City: __________________________  State: _______  Zip Code_______________

Phone: ______________________  Fax and/or e-mail: _______________________

Amount enclosed: $_______  Please make checks payable to CCSAR

Mail to:
CCSAR - Training Director
PO Box 6
Kensington, CT  06037