Instructor | CPR TC

Pre-Approval Instructor Form

Please take a moment to fill out the form.

First Name

Last Name

Phone

Reason for becoming an instructor?

Job Requirment (company name?) or Entrepreneurship?

Where do you plan of teaching out of? (Zipcode)

How many students do you plan to train a month?

Have you been an AHA Instructor before? What years were you active?

Have you been an instructor for another organization (Red Cross, ASHI, etc.)? If so, which one?

Are you transfering TCs? If so, what training center and reason for leaving?

Interested in ACLS BLS PALS Instructor?

BLS

Heartsaver

ACLS

PALS

Who referred you to my website for screening or how did you hear about us?

How soon do you want to be trained as an instructor?

Resume

Upload File

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Upload for other documents (CPR Card, Essentials, and Intructor Card

Upload

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Additional Comments or Concerns?

***DISCLAIMER***

All areas filled out correctly and honestly, will increase the chance of you being approved for training. Please do not skip any required fields and complete them to your best ability.

Thanks for submitting!

Grievance