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Onsite Training Request Form

To receive an onsite course proposal, fill out the form below and our American Heart Association Training Center Coordinator will be in touch with you shortly. If you have questions or concerns that cannot be addressed through this form, please call Cynthia Henney at 541-245-7504.

First Name *

Last Name *

Organization *

Email *

Address *

City *

State *

Zip Code *

Phone Number *

How did you find us? *

Preferred method of contact *

Telephone

Choose your training choice: *

BLS Provider-5 hour class

BLS Provider Recertification-3.5 hour class

Heartsaver First Aid/CPR/AED-5 hour class

Heartsaver CPR/AED-4 hour class

Heartsaver First Aid-3 hours

Expected number of participants *

6-9

10-18

19-27

Preferred time for training *

Morning

Afternoon

Evening

Preferred dates for training *

Any additional comments

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Onsite Training Request Form

Continuing Education & Workforce Development