Instructor Name

Address

Street

City, State Zip

Primary Phone Number

Best to contact

 Days

 Evenings

Email Address

and/or alternative numbers

Scouting Affiliation (required to receive a 50% discount on the price of your class):

Position

Unit Number

 Pack   Troop  Crew      District     Council

 Other

District

Background Experience

Are you currently CPR or First Aid certified?    No ___   Yes ___ Certificate _______________

Are you a teacher or an instructor?                   No ___  Yes ___ Subject  _________________

Training Requirement

To qualify as an instructor candidate for the American Red Cross programs, you must :

1. Be at least 17 years old.

2. Successfully complete the Red Cross Fundamentals of Instructor Training (FIT) course.

3. Successfully complete the instructor course. This includes attending all sessions, demonstration of knowledge, delivering three acceptable teaching presentations and passing the final written test.

If interested in becoming an instructor, complete the form and

send via mail, fax or email to

Nick Geier

Central Maryland Chapter

4800 Mt. Hope Drive

Baltimore, MD 21215

Fax: 410-624-2061

Email: ngeier@arc-cmc.org