Rescue Training International - Instructor Order form
Instructors - complete the required fields and check off the reminders
Lead Instructor Name *
Your answer
Enter course dates *
Include the start and end date
Your answer
Type of course *
Number of book sets you need. Book sets are $55 each + shipping. *
This includes new and recertifying.
Your answer
Location of course *
Include site, city, state and country if other than US
Your answer
Agency/Department Hosting
If this is for an agency/department, type in the name
Your answer
Where do you want the books mailed to? *
Home or work?
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Preferred telephone number *
Your answer
Work telephone number, if other than Preferred.
Your answer
Country *
Email address *
Your answer
Have you completed your annual Lead Instructor test for this course? *
Required
Is there a current Emergency Action Plan for this training site? *
Required
Complete all lines. By completing and submitting this request, I understand that I am responsible for payment in full for the requested materials. Cancellation or transfer of course dates is required 14 days prior to the course. Failure to cancel or transfer less than 14 days prior to course does not negate responsibility for payment. Payment must be made no later than thirty days after the course. *
I understand and agree with terms. Please initial.
Your answer
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