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Outside Student
NRP Registration Form 

All registrations must be received and the class must be paid for no later than 10 business days prior to the course in order for you to receive your book with enough time to adequately prepare and complete the online test. 

 **Find the time you would like to attend on the left, and pick a date to attend that class on the right. Please choose only ONE date and time to attend.

Date to Attend
Last Name
First Name
Middle Initial
Credentials (MD, RN, etc)
Zip Code
Phone Number
Alternate Phone Number
E-mail Address
Fee for Course   $150    
Method of Payment:

If paying by check, please address to:

Department of Life Support Education
Wake Forest Baptist Medical Center
Medical Center Boulevard
Winston-Salem, NC 27157 

If paying by credit card, please call Mikell White at 336-716-2800 once you have received confirmation of your acceptance.

If paying in cash, please deliver in person to the Department of Life Support Education-3rd floor South Building.
We will notify you of your acceptance into the class through the email address you provided.





Quick Reference

Life Support Education
Kathy Nelson

Phone 336-716-2005
Fax 336-716-5927

Contact Kathy

Mikell White

Phone 336-716-2800
Fax 336-716-5927

Contact Mikell


3rd Floor South Building

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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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