Notice to instructors:

In an effort to keep the level of service to instructors to a professional standard, Safety Services has contacted you to ask that you fill out the following form, and fax your current class activity rosters to our office for evaluation/audit. If you have decided to remain active with Safety Services' BLS/CPR training center, fax your course rosters for the past 12 months to: (813) 818-0019. We will complete quality assurance evaluations on a random percentage to be sure that your training courses meet with our professional training center standards.

If you have decided that you no longer wish to offer BLS/CPR classes, and/or you choose not to be affiliated with Safety Services any longer, please fill out the form below, and let us know. We will remove you from our training center roster, and notify ASHI of you decision.

Name: *
E-mail Address: *
Current Phone Number: *		(enter as 8138551225)
Current Mailing Address: *
City, State, Zip Code: *
Alternate Phone/Fax Number: *		(if none enter n/a)
Interested in remaining an instructor?		Yes No

1. We could improve the quality of our training center by:
2. Additional comments that you would like to share about our training center or ideas on how to improve our training center or training center referrals:
We would like to thank you for your time to keep Safety Services up to date with your training center activities. If you have rosters that need to be faxed to our office, please send them to (813) 818-0019. Also, if you have not done so, go to www.communitytrainingcenter.com and register/log-in to the instructor forum. All of the new tests, and forms that you need to do the training classes are there. If you have any questions, please feel free to contact us at (813) 855-1225 or email us for a quicker response.
* Required information (all required number information should be entered with no dashes or periods)