Trainer Request Your Details Organisation Your Name * First Name Last Name Phone Number Website http:// Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Training Information Select the type of training required from the options below. First Aid * First aid at work Paediatric first aid Emergency first aid at work Emergency paediatric first aid Basic life support and management of anaphlaxis Paediatric first aid (Annual Refresher) First aid at work (Annual Refresher) Not Required Prehospital Care * FREC 3 FREC 4 Safe Administration of Lifesaving Medication (SALM) Out of Hospital Adult Immediate Life Support (ILS) Administering Emergency Medical Gases Mentoring Ambulance and Emergency Services Personnel Not Required Moving and Handling * Moving People Safely Principles and Practice of Moving People Safely Not Required Education and Training * Education and Training Level 3 Not Required Number of Trainees * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Do you require a venue to conduct the training * Yes No Address of Venue Fill this section in if you answered No to the previous question Address 1 Address 2 City State/Province Zip/Postal Code Country Training Start Date * This is the start date that you would like the training to commence on taking into account the number of days to run the course you require. All courses must be run on consecutive days. PREHOSPITAL CARE Frec 3 = 5 Day Course Frec 4 = 5 Day Course Safe Administration of Lifesaving Medication (SALM) = 2 Day Course Out of Hospital Adult Immediate Life Support (ILS) = 1 Day Course Administering Emergency Medical Gases = 1 Day Course FIRST AID First Aid at Work = 3 Day Course Paediatric First Aid = 2 Day Course Emergency First Aid at Work = 1 Day Cousre Emergency Paediatric First Aid = 1 Day Course Basic Life Support and Management of Anaphylaxis = 1 Day Cousre First Aid at Work (Annual Refresher) = 1 Day Course Paediatric First Aid (Annual Refresher) = 1 Day Course MOVING AND HANDLING Principles and Practice of Moving People Safely = 1 Day Course Moving People Safely = 2 Day Course MM DD YYYY Thank you for your submission a member of our training team will be in touch shortly.
