Save a Life Initiative Chapter Program Interest Form

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Save a Life Initiative 501c(3) aims to help build resilient communities where individuals possess the skills and confidence to respond effectively in emergencies, thereby saving lives and contributing to a safer, healthier society. As an officially licensed training provider affiliated with the American Red Cross, we offer accessible and comprehensive CPR education and certification. Check out our website for more information about the organization and chapter program: https://www.savealife-initiative.com/

Please fill out the following information for us to get to know you more for the program.

NOTE: THIS FORM IS NON-BINDING AND WILL BE CLOSING ON SUNDAY, SEPTEMBER 15TH.

Email *

Record my email address with my response

Name (First, Last) *

Rising Grade (for 24-25 school year) *

Phone # (optional)

Location (City, State) and High School *

Briefly describe your previous leadership experience (within your school, clubs/organizations, religious groups, family, or wider community)? *

What insight or skills gained from the above experiences do you believe will aid you in starting your own SaLI chapter? In other words, help us understand more about your interest in SaLI.
*

How comfortable are you delivering presentations to groups of people? *

Not comfortable

Very comfortable

How comfortable are you with talking to local community leaders (like school staff or government officials) about hosting events in your area? *

Not comfortable

Very comfortable

Will you be able to hold at least 3 events over the next 6 months? These events could be formal CPR/AED/First Aid certifications or can include informative presentations and seminars and/or workshops for your local community. *

Yes

Other:

Would you be interested in holding fundraising events for your chapter? *

Yes

Other:

Are you open to a short (~15 mins) introductory call to explore mutual fit in July/August? *

Yes

Other:

A copy of your responses will be emailed to .

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