Mobile menu
Menu
Phone
218.485.4481
Moose Lake, Minnesota
Search
Emergency
 

Class Registration

Home / Class Registration

Class/Event Registration

Fill out the form below to register for this event!

 

Name:

Email:

Address:




Phone:

Event/Course:

Event Date:

Time of Event:

Are you a Mercy Hospital employee?

YesNo

How did you hear about the workshop?

Mercy Hospital's WebsiteMercy Hospital's Facebook PageMercy Hospital Newsletter (LifeLine, Mercy Beat)Online SearchOther

If there is a fee for the course, how would you like to make payment?

Online paymentSend check to Mercy Hospital Education DepartmentOther / Not Applicable