Advocate BroMenn Training Center

announces

American Heart Association

20 13 Basic Life Support (CPR)

Instructor Course

Thursday, August 29, 2013

5:30 PM – 10:00 PM

(meal will be provided)

Advocate BroMenn Medical Center

Conference Center Rooms 1 - 3

1304 Franklin Ave, Normal, Illinois

Registration fee is $225.00

Registrants may purchase instructor manuals through a vendor

of their choice or they may include payment with the

registration fee. Required instructor manuals are:

BLS for HCP Instructor Manual (90-1036) &

Heartsaver First Aid/CPR Instructor Manual (90-1029)

Textbook fees are $85.00 (Total fee for course and books $310.00)

Make checks payable to Jan Berlin

To register complete registration form and send with payment to:

Jan Berlin, AHA Regional Faculty

2358 County Road 1100 N

El Paso, Illinois 61738

Registration deadline is Friday, August 16, 2013

(Class size is limited )

Prerequisites for Instructor Candidates:

? Current Healthcare Provider card.

? Completed Instructor Candidate Application (Will be sent to you).

? Agree to teach at least 4 courses in a 2-year period.

? Be aligned with an AHA training center.

? Complete Core Instructor Course (book will be mailed upon receipt of payment).

*Contact Jan Berlin , AHA Regional Faculty, at (309) 268- 5138 for any questions or concerns.

Registration Form

Name: __________________________________________________

Address: ________________________________________________

________________________________________________

Home Phone: ____________________________________________

Cell Phone: _____________________________________________

Work Phone: ____________________________________________

Email Address: __________________________________________

Please attach copy of current Healthcare Provider Card

Mail form and payment to:

Jan Berlin, AHA Regional Faculty

2358 County Road 1100 N

El Paso, Illinois 61738