Less Stress On-Line Registration Form

This form will register you for the selected program. When we receive it, we will email you a confirmation of your registration. Should something happen and you cannot attend the program, we will refund your payment in full if you cancel within 24 hours of the start of the course. Please realize that seating is very limited in some programs and we must adhere to this policy to guarantee everyone a seat in the course. Your courtesy and consideration is much appreciated.

Name
Street
City
State
Zip
Phone
E-Mail Address :

Please register me for the following program:
Program Number:
PAYMENT TYPE:(all registrations must be pre-paid, except EMT CEU volunteers who
MUST [very important] present an EMT-B NJ OEMS eligibility form at the time of the class)

Please select a payment option {money order and check orders must be mailed)


Payment Type:

Card Number:
Card Expiration: Cardholder Name:
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Or print and mail to LESS STRESS INSTRUCTIONAL SERVICES * 138 Buena Vista Ave, Hawthorne, NJ 07506
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