Outside Student ACLS Instructor Registration Form
In addition to this form, please provide a copy of your current BLS card and ACLS card, as well as a completed Instructor Candidate Application. All four sections of the Instructor Candidate Application must be signed and completed before being sent to us. It can be faxed (336 716-5927) or sent through inter-office mail to Life Support Education. We cannot give out materials until we receive the items listed above, in addition to payment.