TS APPLICATION

Kentucky Health & Safety Training

Training Site Application

Interested in becoming an Official American Heart Association Training Site?
Please complete the following application & receive a response from the Training Center with 5-7 business days!

Please complete all required fields below:

How many participants did you instruct per year (BLS & Heartsaver)?

REQUIREMENT: Training Sites are required to maintain Commercial Liability insurance with a limit equal to or greater than $1,000,000 and a deductible no greater than $1,000, regardless of disciplines applied, from a carrier rated A, VII, or better.

This application was completed by (PRINT):

SIGNATURE:
DATE:
Phone number:
Email:
Application Terms & Conditions: By e-signing this application above I have provided Kentucky Health and Safety Training, LLC with truthful and accurate information to be consider as an authorized American Heart Association Training Site under the direction of Kentucky Health and Safety Training. In the event any information is falsified, this application and/or Training Site agreement will be terminated immediately.

Instructions:

This form is to be completed by the Training Site (TS) applicant. A complete application must be submitted for review. I understand and agree to use Enrollware for course records management. I understand I will use eCards for successful student course completion. Use of eCards is required to proceed with the application process. Complete all required information on this form. See checklist at the end of the application for the information to attach. Please send all your documents to Chase Smith. If you have any questions, please contact Chase Smith. Incomplete applications will be returned to the applicant. Only complete applications will be reviewed for content.

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