FAST New Member Registration

This form is for members who have completed a New Volunteer Orientation and FAST Orientation (Operations Training). After completing this form, your email will be added to our list-serve for upcoming trainings, events, and other announcements. Please fill out the form completely. If you are not currently certified in CPR/FA, we will contact you with registration instructions once you complete this form.

FIRST NAME*

LAST NAME*

EMAIL*

CELL PHONE*

CPR EXPIRES (MM/DD/YY)*

FA/LICENSE EXP. (MM/DD/YY)*

MICHIGAN LICENSE*

NONEEMS (MFR, EMT-B, I, P)NURSING (CNA, LPN, RN, NP)PA-C or PHYSICIAN

CERTIFICATIONS

Defensive Driving
Gator Operator
Epi-Pens and Inhalers
Oxygen Administration
Lifeguard