HONG KONG RED CROSS FAT0001E
Health & Care Service Department Revised on: 11/2010
First Aid Training Course ─ Application Form
(For English Course)
(I) Personal Information(please complete this form in BLOCK LETTERS)
Name： / (in English) / (in Chinese)HKID No.： / ( ) / Sex：
Age ： / below 16 16-25 26-35 36-45 46-55 56-65 65 above
Address： / (Provide a self-addressed stamped envelope)
Tel.(Home)： / (Company)： / (Mobile)：
E mail address： / (We will confirm your application by email) / Occupation：
Education： / Primary Secondary Tertiary GraduateSchool
(II) Course(Please the appropriate box)
Standard First Aid Certificate Course / ($360) / Standard First Aid Certificate Refresher Course / ($220) Elementary First Aid Course / ($160) / Elementary Child First Aid Course / ($160)
Integrated CPR Certificate Course / ($580) / Adult CPR Certificate Course / ($230)
ChildCPR Certificate Course / ($230) / Infant CPR Certificate Course / ($230)
Adult CPR AED Course / ($650) / AdultChild CPR & AED Course / ($798)
AEDCourse / ($450) / Domestic Helper First Aid Course / ($340)
Standard First Aid Certificate Refresher & AED Course / ($580) / Others ______(please specify)
Course Code (1st choice)： (2nd choice)： Course Fee：$
If the 1st choice class is full, we will arrange the 2ndchoice class for enrolment (except the class is also full)
(III) Training Material Ordering / Student Special Price / Unit / Total
1) First Aid Lecture Notes + First Aid Education DVD
(for Standard First Aid Certificate /Standard First Aid Certificate Refresher students only) / $90-
2) First Aid Education DVD (Including Cantonese, Putonghua, English and Sign Language) / $50-
3) First Aid Lecture Notes / $65-
4) Bandage Pack(1 dressing gauze, one 5 cm and one 7.5 cm roller bandage and three triangular bandages)
(for Standard First Aid /Standard First Aid Certificate Refresher/Youth First Aid Course) / $40-
5) Life Key Ring / $38-
6) Face Shield (for practice) / $5/ 1piece
$10/ 3 pieces
$18 / 6 pieces
7) Face Shield (for real situation) / $18-
8) Bandage pack (1 dressing gauze, one 5 cm roller bandage and one triangular bandage)
(for Elementary First Aid / Elementary Child First Aid Course) / $25-
Cheque No：______Total (Incl. course fee & training material)：
(IV) Source of Course Information(Please the appropriate box)
HKRC web site Newspaper, Magazine
Recommended by friends or relatives Others(please state：______)
※Personal data provided in this application form will only be used for application and related purpose. Applicant has the right to access and correct this data through written request to Health and Services Department, Hong Kong Red Cross.
Signature： Date：
…………………………………………………..Please fill in the following information ………………….……………...……………
Name: Name:
Address: Address:
______
Enrolment details
Applicants are required to:Complete the application form
Make a crossed cheque payable to: [Hong Kong Red Cross] (Please do not mail cash or promissory notes)
Provide a self-addressed stamped envelope which has pasted on a $1.40 postage stamp
Mail or submit in person to the following address:
Hong Kong Red Cross Health Care Service Dept (Kwai Chung Office)
Rm 1701, Millennium Trade Centre, 56 Kwai Cheong Road, Kwai Chung, N.T
(please indicate " Application for First Aid Training " on envelope) / Office hour
Monday to Friday: 0900 to 1300, 1400 to1730
Saturday: 0900 to 1200
Close onSundays and public holidays
Enquiry hotline: 39710288
Facsimile: 3971 0388
Enrolment requirements
The applicant must be 16 years old or above (except for Youth First Aid Certificate Course).
The enrolment arrangement is based on a first come, first served basis. Applications submitted by post will only be accepted if postmarked no later than the deadline.
The Health & Care Service Department will not accept the application if the information in the application form or the envelope is insufficient or invalid.
The applicant should pay the course fee and training materials with separate crossed cheques.
Please do not mail cash or the promissory note
If necessary, please make copies of all application documents (for example: first aid training curriculum regulation, timetable, all kinds of application forms) for reference. If copies are made in the Health & Care Service Department, the copy charges will be HK$ 1 each page.
The course fee will not be refunded in general, unless the class is full or cancelled.
This First Aid certificate is valid for 3 years, and the enrolment is on a first come, first served basis. Therefore, it is advised that students may need to apply for the Standard First Aid Refresher course before the certificate expiry date. First Aid certificate holders who do not renew the certificate before the expiry date, he/ she will need to take a Standard First Aid course again to obtain the certificate.
The Health & Care Service Department reserves the right to change the First Aid lecturer, class schedule and the venue. If the number of applicants does not meet the standard number of applicants, the Health & Care Service Department has the right to cancel the course. The course fee will be refunded in 4 to 6 weeks starting form the cancellation effective date.
Collection of examination result / course certificate
Candidates please collect the examination result / course certificate at Kwai Chung Office of Health & Care Service Dept. in person.The date for collection will be announced at HKRC web site () about 1 month after examination / completion of course.
Application for deferment of examination
Deferment of examination only applies to the Standard First Aid course or the Standard First Aid Refresher course
Please submit the application 1 week in advance to the scheduled examination day. Complete the "Deferment of Examination Application form and provide a crossed cheque payable to: [Hong Kong Red Cross] of $50. Please state the applicant’s name and Hong Kong Identity Card number at the back. Together with a self-addressed stamped envelope which has pasted on a $1.40 postage stamp, submit these items to the address above by mail or in person. Applications submitted by post will only be accepted if postmarked no later than the deadline
Application for change of student or class
Please submit the application 1 week in advance to the scheduled course. Complete the “Change of Student/ Class Application form ",Application fee for change of student is HKD$50, and for change of class is HK$100. Please also provide a crossed cheque payable to: [Hong Kong Red Cross]. Please state the applicant’s name and Hong Kong Identity Card number at the back. Together with a self-addressed stamped envelope which has pasted on a $1.40 postage stamp, submit these items to the address above by mail or in person. Applications submitted by post will only be accepted if postmarked no later than the deadline
Application for reissuing the First Aid certificate
If students would like to apply for reissuing the First Aid certificate (e.g. losing the certificate), please complete the "Reissuing the First Aid Certificate Application Form ", provide a crossed cheque payable to: [Hong Kong Red Cross] of $100. Please state the applicant’s name and Hong Kong Identity Card number at the back. Together with a self-addressed stamped envelope which has pasted on a $1.40 postage stamp, please submit these items to the address above by mail or in person. The new certificate will be issued 4 weeks after the application is received.
Application for checking the examination result
If the student has any inquiry to the exam result, please complete the “Exam results checking application form ", provide a crossed cheque payable to: [Hong Kong Red Cross] of HK$100. And state the applicant’s name and Hong Kong Identity Card number at the back. Together with a self-addressed stamped envelope which has pasted on a $1.40 postage stamp, then submit these items to the address above by mail or in person.
Personal information collected through application is only for course enrolment purpose. Applicants have rights to check and change the information with written request. The Health & Care Service Department reserves the right to amend the above rights.
Address: Rm 1701, Millennium Trade Centre, 56 Kwai Cheong Road, Kwai Chung, N.T. Tel: 3971 0288 Fax: 3971 0388 Email: