ECSInstitute.org: Academic Training Center Application

Using ECSI for your Course

Online Courses as Supplements

Other Supplemental Material

Academic Training Center Application

EXTREMELY IMPORTANT: This application is intended only for High School, College or University instructors who wish to begin using ECSI training materials at their Academic institution. Individuals or training centers that ARE NOT AFFILIATED with a High School, College or University must instead complete the Educational Center application for community-based training centers.

*Your First Name:
*Your Last Name:
*Educational Center Name:
Web Site:
Department:
*Address:
*City:
*State/Province:
*Country:
*Postal Code:
*Primary Phone:
Secondary Phone:
Department Chair:
Fax:
*E-mail Address:
Some areas of the ECSInstitute.org Web site will be restricted only to Educational Center coordinators. To validate your identity in these areas, please choose a password.
*Password:

*ECSI Programs desired:
Please check off all programs your center is qualified to offer, even if you don’t intend to teach these immediately.
	Approx number of students trained per year
Standard Level First Aid, CPR, AED
Advanced First Aid, CPR, AED
First Responder(Must be certified First Responder or higher.)
Professional Rescuer CPR
CPR only (Lay Person Adult, Child, Infant)
Automated External Defibrillator
First Aid only
Wilderness First Aid
Bloodborne Pathogens
Skills Testing for Online Courses
eACLS™ (Must be an ACLS instructor or equivalent.)
In order to offer the eACLS course and order materials for this title under your ECSI Education Center, please take a moment to fill out the additional short application here: http://www.eacls.com/agree.cfm (This is required in order to offer eACLS)
Pediatric First Aid
Ellis & Associates Lifeguarding (Must be an Ellis & Associate Lifeguard for approval.)
Pet First Aid
Oxygen Administration
Fleet Driver Safety
Sport First Aid
Healthcare Provider CPR
BLAST
Boy Scouts of America Wilderness First Aid 16-hour course