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HELP! I lost my card!
Don’t worry—we can fix that. If a SOLO certification card is lost or damaged, we will replace it with an ecard for a processing fee of $10. You will be emailed an invoice via PayPal upon receipt of this application. We will not process your application until payment has been received. All information MUST be provided. If you are unsure of course dates or other valid information, SOLO will charge $25 to research certification history.

Replacement cards are sent as electronic copies. If you would like a paper or plastic card(s) instead, please check the appropriate box in the form to receive one. 

SOLO also reserves the right to deny a replacement card if proper information is not provided. If you are unsure about dates and locations, we recommend checking bank statements or credit card records as a
reference.

December 5, 2020

First Certification Holder's Name

First Name*

Last Name*

Phone*
First Certification Holder's Date of Birth*
I certify that I am 18 years of age or older
First Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
First Certification Holder's Signature*
Second Certification Holder's Name

First Name*

Last Name*
Second Certification Holder's Date of Birth*
Second Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Third Certification Holder's Name

First Name*

Last Name*
Third Certification Holder's Date of Birth*
Third Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Fourth Certification Holder's Name

First Name*

Last Name*
Fourth Certification Holder's Date of Birth*
Fourth Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Fifth Certification Holder's Name

First Name*

Last Name*
Fifth Certification Holder's Date of Birth*
Fifth Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Sixth Certification Holder's Name

First Name*

Last Name*
Sixth Certification Holder's Date of Birth*
Sixth Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Seventh Certification Holder's Name

First Name*

Last Name*
Seventh Certification Holder's Date of Birth*
Seventh Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Eighth Certification Holder's Name

First Name*

Last Name*
Eighth Certification Holder's Date of Birth*
Eighth Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Ninth Certification Holder's Name

First Name*

Last Name*
Ninth Certification Holder's Date of Birth*
Ninth Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Tenth Certification Holder's Name

First Name*

Last Name*
Tenth Certification Holder's Date of Birth*
Tenth Certification Holder's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Please indicate which certification card(s) you need. *
SOLO CPR
SOLO First Aid
NICA First Aid
WFA
WFR
WEMT

Please fill out the following fields regarding the LAST course you took and were issued cards.

What type of course did you last attend?*
SOLO CPR
First Aid/NICA First Aid
WFA
WFR Recert.
Wild Day
WFR
WEMT

Please provide the start date of the course.

If you are unable to recall the course start date, please list the month and year of the course.

Please provide the location of the course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your course instructor(s).

Please fill out the following fields regarding the ORIGINAL course you took and were issued cards.

Please select who your original course was taken with.*
SOLO
WMA
WMI
Other

If other, provide the name of the issuing organization.

Please provide the start date and location of your original course. Helpful information includes city/town, state, and sponsor. (e.g. SOLO, Conway, NH)

Please provide the name of your original course instructor(s).
If replacing a WFR or WEMT card, I attest that I hold a CPR certification that is current. I understand that if my CPR expires before my wilderness certification, that my SOLO card is not valid until I renew my CPR certification.*
No
Yes
I am not renewing a WFR or WEMT.
I would like a hard copy of my card(s) sent to me in the follow form and accept the associated fee(s).
$5 additional per paper card
$10 additional per plastic card
I only need an ecard.
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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