Request for CPR Certification

Today's Date * +

Name of Teacher/Requestor *

Name of Program and High School *

Program Manager Approved *

Class Period(s) *

Number of Students *

Please suggest three (3) potential dates for your students' CPR certifications (if you are CPR uncertified).

CPR Certification Date +

CPR Courses Offered

Please read instructions carefully before moving foward!

Please choose the CPR course required for your class or program.

Select the CPR Course needed for your class. *

	You must check at one item.
Basic Life Support CPR/AED	You must check at one item.

1. Simply click on the course link and download the document by selecting the ↓ icon located on the upper left corner.

2. Complete the Course Information for your class, making sure to accurately enter the Student's First and Last Name, Phone Number, and Email address.

3. Save the completed course information form and upload them to the "Attachments" section.

Note: Please DO NOT use the Student's school email, they are blocked from receiving emails from American Heart Association.

Emails provided is where students will receive their CPR Card from the American Heart Association.

Basic Life Support CPR/AED Course

Please upload your complete Course document. *

Should you have further questions, please reach out to our Office Assistant, Angelica Macias, at angelica_macias@cry-rop.org. Please allow 3 to 5 business days for Angelica to acknowledge submission of your CPR request. Thank you!