GROUP REQUEST FORM | GARCIA SERVICES, HEALTH AND EDUCATION

Does your business, college or group require CPR, AED, First Aid and/or Universal Precautions/ Bloodborne Pathogen Training?

Please contact us at ADMIN@GARCIASHAE.COM and inform us of what course(s) you’ll need and when (SATURDAY) you’d like it completed. We will contact you shortly to discuss your training needs.

Please note that all training is conducted on Saturdays only.

GROUP/ CORPORATE REQUEST FORM

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Fields marked with an * are required

First Name *

Last Name *

Address 1 *

Address 2

City *

Zip / Post Code *

Email *

Phone *

Course Requested for HEALTHCARE PROVIDERS (Check ONLY One)

BLS CPR + AED (INITIAL) for Healthcare Providers ONLY

BLS CPR + AED (RENEWAL) for Healthcare Providers Only

Course Requested for NON- HEALTHCARE PROVIDERS (Check ONLY One)

COMMUNITY CPR + AED

COMMUNITY CPR + AED + First Aid

Select an OSHA Related Course (Healthcare and Non- Healthcare Providers)

Bloodborne Pathogen and Universal Precautions

How Many in the Group?

Provide Course At Your Site? Please Check One (Corporate, Collegiate, Or Group Setting ONLY)

Yes

If Training for Corporate, Collegiate or Group Setting, Requested At Your Site, Please Provide Your Site's Address Below.

Since we could only acccomodate this at your site during a Saturday, please provide us at least 3 possible dates that is convenient for you. Thank you.

Other Comments, Questions or Concers