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Valley Rescue Training - Training Request

Submit this form to request group, on-site, department, school, daycare, or organization training. We will contact you directly to coordinate scheduling, pricing, and course details.

If you have questions or are unsure of what your training needs are, please call or email us at (330) 647-1680 or valleyrescuetraining@icloud.com for help. Thank you for choosing Valley Rescue Training

Full Name

*

Email

*

Phone Number

*

Is this training for an organization or business?

*

Is this training for an organization or business?

Yes

No

Training Needed

*

Training Needed

Heartsaver CPR/AED

CPR / AED / First Aid

Basic Life Support for Healthcare Providers (BLS)

Advanced Cardiac Life Support for Healthcare Providers (ACLS)

Pediatric Advanced Life Support for Healthcare Providers (PALS)

STOP THE BLEED

Bloodborne Pathogens

Not Sure / Need help deciding

Approximate Number of Students

*

Do you want on-site training at your location or do you prefer to come to us?

*

Do you want on-site training at your location or do you prefer to come to us?

A

On-site training at my location or place of business

B

We prefer to travel to a location set by Valley Rescue Training

Do you have a preferred date for training?

*