NSTS Form

CPR/AED* and First Aid by National Safety Training Service, LLC

The National Safety Training Service, LLC offers Adult/Pediatric First Aid, CPR/AED and Bloodborne Pathogens (UP) training for childcare home and Center providers. Participants pay: $65.00 for taking both CPR/AED and First Aid; $40.00 for CPR/AED; $35.00 for First Aid; and $5.00 for UP. Class Timings are First Aid: 8:00 AM - 11:00 AM, UP: 11:00 AM - 12:00 PM, CPR/AED: 12:30 PM - 2:30 PM Plan to bring a brown bag lunch or purchase a quick lunch in the area. In case of bad weather, call NSTS at 366-4769 after 6:30 a.m. on the day of class or check our web site www.NSTSsafety.com to see if class is cancelled. Class begins promptly on the hour. In order to get full credit for the course, please be on time!

* The American Heart Association now requires all CPR classes to teach AED skills; the issued card will state it is an AED card with CPR skills.

CLASS TIMES
First Aid	8:00 AM - 11:00 AM
UP	11:00 AM - 12:00 PM
CPR/AED	12:30 PM - 2:30 PM

Class Name	Location	Date	Time
3 yr. Adult/Ped. FA & 2 yr. Adult Ped. CPR & 1 yr BBP/Universal Precau.	CR - Plumbers Training Center 5101 J Street SW	5/18/2013	8:00:00 AM - 2:30:00 PM

3 yr. Adult/Ped. FA & 2 yr. Adult Ped. CPR & 1 yr BBP/Universal Precau.	CR - Plumbers Training Center 5101 J Street SW	6/15/2013	8:00:00 AM - 2:30:00 PM

3 yr. Adult/Ped. FA & 2 yr. Adult Ped. CPR & 1 yr BBP/Universal Precau.	CR - Plumbers Training Center 5101 J Street SW	7/16/2013	6:00:00 PM - 9:00:00 PM

3 yr. Adult/Ped. FA & 2 yr. Adult Ped. CPR & 1 yr BBP/Universal Precau.	CR - Plumbers Training Center 5101 J Street SW	7/17/2013	6:00:00 PM - 9:00:00 PM

THIS IS FOR CEDAR RAPIDS & DAVENPORT

National Safety Council First Aid Cards

First Aid is good for 3 years

CPR/AED is good for 2 years

UP is good for 1 year

Introducing Payments through PayPal. (You will NOT be required to print this form and mail it to NSTS if you complete your payment through PayPal)

Mail In Registration Sheet (If NOT registering through PayPal)

To Register: Fill out the registration form below and mail with Appropriate fee. Registration & payment MUST be received by NSTS, LLC ONE (1) WEEK PRIOR TO CLASS. Call Kate White at 366-4769 for more information. No registrations will be accepted over the phone. Class will be filled on a first come, first served basis. You will be notified if there is not room on the date you registered or if there are any class changes. No refunds or reschedules will be allowed without 24 hours notice to NSTS.

Questions, concerns and needs for special accomodations should be directed to the National Safety Training Service at 319-322-4769

Please keep top part of sheet for your reference.

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National Safety Training Service, LLC CPR/AED - First Aid Registration

Class: (circle date below)

5/18/2013
Cedar Rapids

6/15/2013
Cedar Rapids

7/16/2013
Cedar Rapids

7/17/2013
Cedar Rapids

Name_____________________________________ Phone_____________________

Center Address___________________________________

City ________________________ Zip___________ County ___________

I am (Check One) :

____ Registered Home Child Caregiver

____ Center Staff at ________________________________

____ DHS contract/certificate ________ HeadStart ________ Other

Check (X)

___ FA & CPR/AED--$65

___ Bloodborne/UP--$5

___ 1st Aid ONLY--$35 (Good for 3 Years)

___ CPR/AED ONLY--$40 (Good for 2 Years)

Make checks payable to: Kate White
Mail to: NSTS, 225 25th Street Drive SE, Cedar Rapids, IA 52403.

NO REFUNDS OR RESCHEDULES WITHOUT 24 HOURS NOTICE TO NSTS!

"Duplicate" cards are $5 each. Request and payment must be mailed to NSTS; 225 25th Street Drive SE, Cedar Rapids, Iowa 52403.

Include your NAME
WHEN you took the class
Name of TOWN where you took the class
WHICH CARDS you need.
ADDRESS where you wish to have the card or cards mailed.