COURSE OUTLINE The CPR + AED Instructor Programme is a certified 6 hours course. The course content includes the following modules : CARDIO-PULMONARY RESUSCITATION (CPR) + AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) INSTRUCTOR Principles of Teaching and Learning Principles of Evaluation Manikin Maintenance and Troubleshooting Practical Teaching and Assessment At the end of the programme, participants are required to undergo a practical assessment. Upon passing the practical test, trainee-instructors are required to undergo 2 rounds of assessment before they are issued the CPR + AED instructor certificate. Please note that IMSE will not be providing the 2 rounds of assessment. Participants are advised to approach other NRC accredited training centres for the 2 rounds of assessment. Upon the successful completion of the 2 rounds of assessment, the training centre is to submit the assessment form to IMSE for the issuance of the Instructor certificate. This certificate is valid for 2 years and is renewable if the instructor has instructed at least 2 CPR + AED Courses per year in any National Resuscitation Council (NRC) Accredited Training Centre. ELIGIBILITY A valid CPR + AED Certificate from a NRC accredited Training Centre. An interest and commitment to instruct CPR + AED Courses. COURSE DATE Refer to IMSE Training Calendar for Course Date COURSE FEE SGD 200.00 + 7% GST = SGD 214.00 COURSE MATERIALS It will only be given on course day. However, reminder email & link to download the book will be emailed 3 weeks prior to course. VENUE Institute for Medical Simulation & Education (SGH-IMSE) 167 Jalan Bukit Merah, Connection One, Tower 5, #03-10 Singapore 150167 The objective of CPR + AED Course is to provide participants with the life-saving skill of CardioPulmonary Resuscitation (CPR) and Automatic External Defibrillator (AED) to respond to cardiac emergency situations. For more information, please contact: Institute for Medical Simulation & Education (IMSE) Tel: (65) 6326 6885 / (65) 6321 3651 Fax: (65) 6878 0495 Email: imse@sgh.com.sg Website: http://www.sgh.com.sg/SIMSE CPR+AED INSTRUCTOR COURSE REGISTRATION FORM Email to : imse@sgh.com.sg / Fax to: 6878-0495 Please read the Terms & Conditions carefully before registering. By registering, you acknowledge that you have read, understood and agree to the Terms & Conditions set out below: TERMS & CONDITIONS Cancellations and Postponement – must be advised in writing or via email Amount i.e. Course on 16 July 2015 refundable: More than 5 working days* Full refund Informed on or before 09 July 2015 Less than 5 working days* No refund Informed after 09 July 2015 *Working days refer to Mon – Fri (excluding Public holidays) However, replacement of eligible participants is allowed. Informed IMSE: IMSE reserves the right to cancel the course and fully refund the participants should unforeseen circumstances necessitate it. Privacy Statement IMSE is committed to protecting your privacy and the confidentiality and security of personal information provided by you to us. The personal information you provide in this form will be used by IMSE to: Process your registration form, which may include updating your record, profile information and issuing of certificate. Contact you in the event of cancellation or any further clarification relating to the course registration. COURSE DETAILS Course Date : Course Time : Pre-requisite (CPR+AED certificate) : ☐ Issued by SGH-IMSE ☐ Issued by others (Please attach a copy) PARTICIPANT DETAILS Full Name : Institution : Department : NRIC / FIN / Passport No : Tel / Mobile : Email address : Address : REGISTRATION FEES (inclusive of 7% Goods and Services Tax (GST)) Participants Responsibility to IMSE 1. Participants cannot successfully complete the course unless they attend all the lectures and skills practice. 2. Participants who are late for more than 1.5 hours from the stated start time will not be able to join the course and deemed as absent. Course fees will not be refunded. 3. Participants are to arrange own parking. 4. IMSE will not be liable for loss of personal property. SGD 214.00 Media Release Authority During your participation in our courses, still photographs may be taken that at times IMSE may use for educational, administration or promotional purposes. Attention to: (covers the cost of course manual & certificates) PAYMENT METHOD (Please wait for our email before proceeding to make cash / cheque payment) ☐ By CASH (Please make cash payment at IMSE) ☐ By CHEQUE (Only cheques from Singapore banks are accepted) (Payable to: “Singapore General Hospital Pte Ltd” and indicate your name & “CPR+AED <course date>” on the reverse side. ☐ BY INVOICE – Others (only for local corporate registration) – Invoice will be sent after the course. Organization: Department: By providing the information set out in this form and submitting the same to you, I can confirm that I have read, understood and consent to the SingHealth Data Protection Policy, a copy of which is available at http://www.singhealth.com.sg/pdpa. Address: 05 June 2015