Request of Eligibility

Recertification training is open only to currently certified instructors who have met the eligibility criteria. To verify your eligibility and begin the registration process, please complete the form below.

Your Name (required)

Your Email (required)

Type of certification:  Basic Restraint

Date of your last Certification/Recertification:

Date and location of the training you hope to attend:
Date:

Location:

I will be paying by check.

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