Request for Quote

CONTACT INFORMATION

What's your first name?

And your last name?* This field is required.

What's your name?* This field is required.

First Name

Last Name

How about your email address:* This field is required.No spam - I promise!

Your information is safe with us!

Phone number:* This field is required.Email is generally preferred when responding to a quote but sometimes a phone call is best. :)

Again - your information is safe with us!

Name of agency you're representing:

Zip Code:* This field is required.Where the training will take place

Which class are you interested in?* This field is required.If unsure, make your best guess and let me know your questions in the comments section later in this request.

CPR, AED, & First Aid for Adults

CPR, AED, & First Aid for Infant, Children, & Adults

CPR & AED for Adults

CPR & AED for Infant, Children, & Adults

Bloodborne Pathogens

CPR, AED, & First Aid for Infant, Children & Adults - great! Do you require an EMSA Sticker?* This field is required.CA EMSA Stickers apply to Licensed Child Care Providers, Bus Drivers, and other professions as required under Title 22 of California State Law.

Yes - I'm a child care worker

Yes - I'm a bus driver

Since I require an EMSA Sticker, I understand that my class must include 4 hours of CPR and 4 hours of First Aid (8 hours total).* This field is required.The 8-hour class is required for both initial and re-certification classes.

Yes

I would like our 8-hour class to be:* This field is required.

From 9:00 am - 5:30pm with a 30 minute lunch

Split up - 4 hours of First Aid one day, and 4 hours of CPR another day.

Not sure.

Other

How many students need to get certified?* This field is required.

Which population should your class be tailored to?* This field is required.Who are you most likely to apply your skills to? -- Choose as many as apply -- If you are unsure, select "General Population"

General Population

Mental Health

Intellectual Disabilities

Long-Term Care

Medically Fragile

Children

Elderly

Other

Which class layout do you prefer?* This field is required.

Entirely onsite

Blended online with onsite skills verification

I'm not sure

When completing a blended program, all students will need to fully complete the online portion before the onsite skills verification can take place.* This field is required.It is best to complete the online portion within 5-10 days so the information is fresh for the skills verification.

I understand.

I have some questions

What are you questions/concerns about the blended training?

What type of workbook and certification do you prefer?DIGITAL: The Digital Book can be downloaded as a pdf file to most devices | Certification is always available online; can be printed and saved to any device // PHYSICAL: Book and certification are physical | Copies of certification can be made. (+ $6/book) // Last minute classes may require the digital option depending on current stock

Digital

Physical

Select your preferred training days and start times belowExample: Mark if the first box if you'd like to start the class on a Monday at 8am

Let us know if you have a particular date in mind:

Additional comments or questions:

How did you hear about Hands Down CPR?* This field is required.

Web Search

Post-Card

From a friend

Facebook

Cal eProcure

Other