Medication Administration Form

Step 1 of 2

The Medication Course is delivered using Team Skype. You will receive an email, closer to the date of your course with a Skype link.
I am interested in taking the Medication Administration Course*
- Yes
Choose Course Date*
Confirm Course Date*

Please confirm the date of your selection

Name*
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Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Email*
Enter Email Confirm Email
Phone*
Medication Administration Course ($85+GST)
Price:
Total
$ 0.00 CAD
CANCELLATION/RESCHEDULING POLICY
1. This course is final sale and any cancellations or reschedules for any reason will result in a loss of your registration fee. You must sign into your virtual course on time.
2. To receive a certificate you must successfully complete an assignment. This assignment must be completed within three days after completion of the virtual session. Any submission after this timeline will result in an incomplete and your assignment will not be corrected.
Breath for Life Does Not Cancel courses that you commit to. Breath for Life would like to thank you for your patronage.
Please Note:

Payment must be received in advance to attend this course. Provide debit or credit card information in the payment section below and click on the submit button to complete your registration and payment.
By entering your name in the space provided you acknowledge that you have read, understand and agree to the specified policies. I also understand and accept that the purchase of this course will appear as Breath for Life Inc on my credit card statement and that the amount that will appear on my credit card will not be contested as a fraudulent charge.*

By entering your name you are accepting the policies, terms and conditions of this purchase.
I would like to pay for this course.*
- Yes
Payment - We accept the following Debit & Credit Cards*

American Express
MasterCard
Visa
Supported Credit Cards: American Express, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
For e-transfer payments please email Breath for Life: breathforlifeinc@shaw.ca
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Medication Administration Form

Step 1 of 2

CANCELLATION/RESCHEDULING POLICY