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Instructor Application
Contact us at (256) 522-9867 or cbrodan12@gmail.com
Website holusboluscorp.com
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* Indicates required question
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
What days can you teach?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Required
Can you commit to a schedule prior to class starting?
*
Yes
No
What classes can you teach?
*
BLS
ACLS
PALS
ITLS
PHTLS
Handtevy
EMT
AEMT
Other:
Required
What is your license level?
*
EMT
AEMT
Paramedic
CC Paramedic
Nurse
Other:
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