PE Web

Registration

Please complete this form to obtain an individual account and access the course. Fields marked with an asterisk(*) are required. If you have already registered, please Login.

Location* - Please indicate your location as one of the following:

Us state

OR Canadian province territory

OR Other country

Enter your name as you would like it appear on your certificate

First name* Mi Last name*

Branch of service*

Degree*

Profession* If other, please specify:

Years of experience working with trauma victims*

Enter your email address. This will serve as your user identification every time you login to the course.

Email*

Enter your password. Your password should contain at least 6 characters and may include letters, numbers, underscores and hypens.

Password*

Password confirmation*