ECSInstitute.org: Partnership Application Form

Private Member Login

Find an ECSI Educational Center

2005 CPR and ECC Guideline Changes

Our Medical Partners

Corporate Partners

ECSI Merchandise

Partnership Application Form

Thank you for your interest in partnering with the Emergency Care and Safety Institute (ECSI). This partnership will allow your company or organization to reach a wider audience and give you the opportunity to advertise your products and services to our Members. Any specials or discounts you offer will be made available to ECSI Members only.

If you do not wish to submit your application electronically
Click here to download an application to partner with the ECSI.

Fields with a red * are required.

* Name of Company/Organization:

* Contact person:

* Street Address:

* City:

* State:

* Zip or Postal Code:

* Email:

* Telephone Number:	Fax Number:
555-555-5555	555-555-5555

* Website:

* Please provide a brief description of your company and a summary of what you offer (50 words or less):

Please provide any discounts you wish to offer to ECSI Education Centers and Instructors, including any coupon codes they’ll need to reference in order to receive special offer. Any discounts or specials you wish to offer will be available only to ECSI members in the private members area of the website:

Please email a jpeg file of your company logo to lbyrd@ECSInstitute.org if you wish to have this listed on the ECSI website.

Thank you for partnering with the Emergency Care and Safety Institute. We welcome any additional comments or suggestions.

Lani Byrd

ECSI Membership Director

800.541.5691

Email: lbyrd@ECSInstitute.org

www.ECSInstitute.org