2. Do NOT Create a Login Profile

   You do not need to create a profile or log in to fill out this form. 

4. Request a Lifesaving Skills Training (CPR and Stop the Bleed)

   Thank you for your interest in learning lifesaving skills, such as CPR and bleeding control techniques. These skills save lives when performed by everyday citizens before first responders arrive to an emergency.

   Please fill out the following form, so we can begin the process of setting up a custom training for your school group. All training classes are free. PLEASE NOTE: For any training, we will need adequate floor space for participants to practice CPR and other lifesaving skills. 

6. Name*
7. Email Address*
9. School*
10. School Address*
12. City
13. State
14. Zip Code
16. Requestor's Phone Number*
17. School's Phone Number*
19. Type of Class (Health, History, Athletics, Staff Only, Entire School, etc.)*
20. Approximate Number of Students/Staff*
22. Requested Dates

    Please select dates that are at least three weeks out from today, so we can have adequate time to arrange your training with our staff. 

24. Requested Date/Time*
    Requested Date/Time Start Date

    Requested Date/Time Start Time

    —

    Requested Date/Time End Date

    Requested Date/Time End Time
25. Alternative Date/Time*
    Alternative Date/Time Start Date

    Alternative Date/Time Start Time

    —

    Alternative Date/Time End Date

    Alternative Date/Time End Time
26. Alternative Date/Time*
    Alternative Date/Time Start Date

    Alternative Date/Time Start Time

    —

    Alternative Date/Time End Date

    Alternative Date/Time End Time
28. Skills Requested*

    Please select which lifesaving skills you'd like for our instructors to teach your group. Select all that apply.

    1. Hands-only CPR/AED use
    2. Bleeding control techniques (applying a tourniquet, packing a wound, etc.)
    3. Choking response
    4. Other
30. Will audio/video equipment be available for the class?

    A/V equipment is not required for the training, but North Metro instructors may utilize video if the class setting allows. Additionally, if the training involves a large group size and venue, instructors may utilize audio equipment. If your school does not have audio equipment, North Metro Fire can bring it's own audio equipment for the training. 

    1. Yes
    2. No
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field