Training Center Alignment

Thank you for your interest in joining our training center Healthline First Aid & HeartCert – WI20914

Please fill out the form completely below and include a copy of your provider and instructor cards (if applicable). Please see our policies within this page. Filling out this form acknowledges you have read and will adhere to all of these policies as well as all applicable American Heart Association regulations. New instructors must complete an approved instructor course and be monitored/approved to teach and align. Instructors must instruct 4 courses over two years and attend an instructor renewal course to maintain instructor status. Instructor cards are $5. Note that forms mentioning only ‘HeartCert’ apply to the training center of Healthline First Aid & HeartCert – WI20914. Instructors and training sites will be required to use an approved program for tracking students and courses for quality assurance.

Please let us know of any questions or concerns as we are happy to help and to have you onboard!

Name
Contact Phone Number
Contact E-mail Address
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Upload current provider level and/or instructor cards
Upload other applicable forms/files here
Consent*
I agree to all of the American Heart and Healthline First Aid & HeartCert policies (found on the side or bottom of this page)
Checking this box and continuing indicates your authorized agreement and signature of all policies.

You acknowledge that you have a current provider level certification for the level of classes you will instruct and will maintain it's status as well as that you will maintain instructor status by attending required renewal courses, paying any applicable dues and maintaining all statuses required to be a valid instructor in good standing.

All instructors and training sites must adhere strictly to all training center and American Heart Association rules, regulations, policies including but not limited to dispute resolution, decontamination, card issuing and adhere to the AHA PAM.

Clicking this box indicates agreement to all policies or you may print/sign and upload above.
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