Apply for CPR Instructor (Independent Contractor)

Personal Information

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Address Information

Address *

Line 1

Line 2

City

State

Zip Code

Country

Identification and Certification Upload

Please attach Driver's License *

Max file size: 20MB

Upload Completed Form W-9 *

Max file size: 20MB

Upload Current Instructor Certifications (AHA, Red Cross, ASHI, etc.) *

Max file size: 20MB

Availability

Preferred Location(s) for Teaching *

Equipment Details

Do you have your own equipment? *

Yes No

If Yes, list the equipment (Manikins, AED trainers, etc.) *

References

Name *

First

Last

Relationship *

Phone Number *

Name *

First

Last

Relationship *

Phone Number *

Agreement to Independent Contractor Terms

Status & Services: I am an independent contractor using my own equipment to provide CPR, First Aid, and AED services.
Compensation & Term: Compensation will be as agreed, and the agreement is effective until terminated by either party. I acknowledge my responsibility for taxes.
Legal Obligations: I will adhere to all confidentiality agreements, comply with laws, and indemnify the Company against claims arising from my services.

Agreement & Digital Signature: I agree to the summarized terms and conditions as an Independent Contractor for Attentive Safety LLC. *

Yes No

Digital Signature (Type Full Name): *

Submit

CPR and Safety Training

American Heart Association (AHA) Instructor-Led Courses

Health & Safety Institute (HSI) Instructor Led Courses

Drug Testing

5 Panel Urine Drug Test
10 Panel Urine Drug Test

Fingerprinting

Ink Fingerprinting

Business Hours: Open 7 days a week, 10:00am - 10:00pm EST by appointment only.
Call us at: (877)531-2226 Monday-Saturday 10:00am-3:00pm EST

Terms and Conditions: All courses are non-refundable. If you are late or do not attend, you forfeit your payment. Please contact your employer or school to ensure that you are selecting the correct course prior to paying. You may reschedule prior to your class time.

Apply for CPR Instructor (Independent Contractor)