Wilderness Medicine Registration

First Name * Required
Last Name * Required
Preferred Name
Pronouns * Required
Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number * Required
Email * Required
Date of Birth * Required
MM slash DD slash YYYY
Student ID Number (for K students) * Required
WFA/Re-cert students: Would you like to add CPR? * Required
- Yes – requires an additional fee. Class typically occurs for ~2 hours after the first day’s class
- No – I have current CPR or plan to acquire it at another time
- I’m registering for WFR [CPR is included in the course]
Are you using this course to recertify a current wilderness medical certification? * Required
- No
- Yes
If yes, which certification do you hold? * Required
- AWFA/WAFA
- WFR
- WEMT
What month and year did you take the course? * Required
What organization is the certification from? * Required
Comments:
If the certification is NOT from one of the organizations listed above you may not be eligible to recertify through the course. Please contact OutdoorPrograms@kzoo.edu to verify your eligibility for re-certification before completing your registration.
For those recertifying — Please include a list of *Topics you've heard have changed since your certification *Topics you're feeling rusty on *Topics you never felt very confident on *New/Other topics you'd like to explore more * Required