Date Submitted: Updated March 2019
If your will accept course participants from outside your institution,
please give a contact name and phone number.
BLS INSTRUCTOR COURSE/BLS INSTRUCTOR TRAINER COURSE
P
RE-COURSE AGREEMENT
BLS Instructor Course BLS Instructor Trainer Course
Course Site:
Course Site Address:
Course Dates:
Course Times:
Lead Instructor:
Lead Instructor’s Signature:
Submit this completed form no later than 30 days prior to the scheduled start date of the
course.
North Georgia Technical College
Attn: Leslie Foster
PO Box 65
Clarkesville, GA 30523
click to sign
signature
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