Center for Public Safety Training


American Heart Association CPR, First Aid, Bloodborne Pathogen and AED Trainings.

Course Number /Equipment rental request form. TWO WEEK NOTICE IS NEEDED!

Lead Instructor

 * required

Date course is being held.

 * required

Course being taught.

Check if a AHA First Aid or Ped First Aid will it be a Total course AKA OSHA approved

If you are teaching an online course and would like to request online keys please provide number of keys you need. An invoice will be forwarded to you. Keys will not be released until invoice is paid. Keys are non refundable

Company name and address where course is being held. (If not at a company list private residence.)


Start time of course.

 * required

Billing address (if different than course location)


Tenative # of students (you will not be billed on this #)


Will you be requesting equipment - Type in equipment needed.

Equipment pick up location:

Each student needs a book for every course. If a book is not given to each student AHA completion cards can not be released as per AHA & CPST policies (effective 7-1-2013). Please contact CPST for AHA's library policies for HCP courses conducted at specific locations only.

Please specify number of books you need to purchase or who you purchased your books thru if you ordered books on your own. Put library if you are using libraried books.

 * required

E-mail/Phone #

 * required