Student Name *

If you are requesting group training(s), please type "Group" in the boxes below

First Name

Last Name

Student Phone *

(###)

###

####

Requested Training Date *

MM

DD

YYYY

Which Training Program Are You Interested In? *

Package 1: AHA BLS and Inservices - $90.00

Package 2: AHA ACLS and BLS Certification - $150.00

Package 3: ASHI CPR, AED, First Aid and Inservices - $95.00

Package 4: Inservices Package (MEDS, BBP, HIV, ALZ, DV, HIP) - $60.00

Program 1: Home Health Aide Program - $380.00

Program 3: High School Diploma - $250.00

Course 1: BLS/CPR (American Heart Association) - $45.00

Course 2: AHA ACLS Renewal - $120.00

Course 3: ASHI CPR and First Aid - $45.00

Course 4: ASHI CPR and AED - $25.00

Course 5: ASHI First Aid - $25.00

Course 6: BBP/ Infection Control (BBP) & HIV/AIDS/OSHA - 4 hrs - $30.00

Course 7: Assisting w/ Self-Administration of Meds - 6 hrs - $15.00

Course 8 Alzheimer’s Disease Part 1 & 2 - 4 hrs - $15.00

Course 9: Domestic Violence - 2 hrs - $15.00

Course 10: Residents Rights - 1 hr - $15.00

Course 11: Incident Reporting - 2 hrs - $15.00

Course 12: Prevention of Medical Errors - 2 hrs - $15.00

Course 13: Medical Record Documentation and Legal Aspects - 2 hrs - $15.00

Course 14: Communicating with the Cognitively Impaired - 1 hr - $15.00

Course 15: Caring for Persons with Intellectual Disabilities – 4 hrs - $15.00

Course 16: Zero Tolerance - $20.00

Course 17: Direct Care Core Competencies - $25.00

Course 18: HIPAA - $15.00