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REGISTRATION IS A TWO STEP PROCESS

Pre-registration and pre-payment are required:  To complete payment, first click on the Buy Now link below to be directed to PayPal (no PayPal account required). After payment is sucessfully completed, you should be directed back to this page. If you are not redirected to this page, please manually return to this page to complete and submit the registration information. Registration confirmations are usually issued 48-72 hours after both payment and registration are complete.

Course Fee without the textbook is $65 if received on or before July 5, 2014.  If received on or after July 6, 2014, the fee is $125 and is subject to seating availability.

Textbooks can be purchased on site for $75.00 each. 

There is no fee for the ITLS TN Instructor, Affiliate Faculty and Course Coordinator Update. However, pre-registration is required.

 

Please select one class and one date from the choices listed to the right:

ITLS TN is offering the following courses on the following dates.  Please select the 1) appropriate class and 2) the date which you will participate.

ITLS TN Instructor, Affiliate Faculty and Course Coordinator Update (no fee)
ITLS Initial Instructor Course, for Providers with Instructor Potential
PHTLS or ATLS Instructors wanting to teach ITLS courses

Sunday 16 FEB 2014, Delta Medical Center, Memphis TN, 9am - 6pm
Tuesday, 15 JUL 2014, Hilton Memphis, Memphis TN, 1:00pm - 5pm

NAME as it appears on your certificate or license

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Phone Contact Number with Area Code
(xxx) xxx-xxxx

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Email address

Email is our primary means of communication. Please provide an email address you will check regularily and take the proper steps to allow communications from iltstn@bellsouth.net.

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Home Mailing Address

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City, State, Zip/Postal Code

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Gender (M or F)

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Date of Birth (MM/DD/YYYY)

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Employer

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Assignment/Department/Shift

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Level of Certification or Licensure
(EMT-P, EMT-IV, EMT-B, FR, PA, MD, RN, APN, etc) 

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State of Licensure

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State Certification or License Number

please do not enter your renewal number - enter n/a if not applicable

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State Certification / License Expiration Date (MM/DD/YYYY)

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National Registry Number

enter n/a if not applicable

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National Registry Expiration (MM/DD/YYYY)

enter n/a if not applicable

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