CLASS REQUEST INFORMATION SHEET

CLASS REQUEST FORM

EdCor can conduct any of our class types at your office, facility or you can have a private class at an EdCor office. Advanced lead time for the class request and date options greatly help in confirming instructors and the the class.

Complete the information you can for your class request. Once it is submitted EdCor will contact you for scheduleing and confirmation. Any Additional information or questions can be entered at the bottom in the Additional InformationQuestions section.

Effective 1 Aug 2026 there is $50.00 private class fee for classes within 25 miles. Classes further than 25 miles expenses can be estimated as part of the scheduling process.

Contact Information

Name of Company or Facility/Location

Name of Person Completing Form

If different than the Class Point Person

Class Coordinator

Title/Department

Email Address

example@example.com

Phone Number

Preferred Contact Method

Send Certification IDs to:

If a listing is needed separate from the students providing their certifications.

COID # / COST CENTER / Dept Code

If needed for Invoicing

Billing Contact

Billing Contact Name

Billing Contact Email Address

example@example.com

Billing Contact Phone Number

Class Information

Preferred class dates, times, class type and number of students.

Preferred Class Date

For two day classes this would be the first date

Class Time

Enter preferred start time if you prefer a specific time or enter Morning, Afternoon, Evening or Flexible.

Alternate Class Date #1

Date

Alternate Class Date #2

Date

Class Type

Heartsaver Class Modules

BLS Class Formats

HeartSaver Class Formats

ACLS/PALS Class Formats

Will Students be renewing their BLS during the ACLS/PALS class?

Number of students

The number of students expected for the class or a range of the number of students

Private Class Student Requirements

CPR (BLS and HeartSaver) Classes
- Minumum number of students is 5 students per session.
- Classes of 10 - 13 students, the class will be scheduled as multiple sessions with a single instructor. Sessions can be back-to-back or different days to accomodate differences in schedules.
- For classes of 14 - 18 students, the class can be scheduled as multiple sessions or a single session with two instructors. If scheduled as a single sesion with two instructors the minimum invoice will be for 14 students.
ACLS, PALS, PEARS and Megacode Classes
- Minumum number of students is 4 students per session.
- For classes with more than 9 or more students, the class will be scheduled as multiple sessions.
TNCC, ENPC and NRP Classes
- Minumum number of students is 4 students per session.
- For classes with more than 7 or more students, the class will be scheduled as multiple sessions.
QMAP, ECG/EKG Classes
- Minumum number of students is 8 students per session.
- For classes with more than 15 or more students, the class will be scheduled as multiple sessions.
- Note: Depending on the class size the orginizaiton may need to provide a test proctor on day 2 to allow for written testing and practicum testing to overlap.

Classes smaller than the minimum number of students can be scheduled, but will be invoiced based upon the student minimum.

For large group classes please enter the estimated number of students and EdCor will discuss scheduling options when we contact you.

Will you need new course books? Please note: AHA books are required and must be the current 2025 guidelines edition BLS, ACLS, and PALS. Other book current editions are - TNCC 9th edition, ENPC 6th edition and NRP 8th edition

Names and Email Addresses of Class Participants (if known)

This will allow us to register them in the class and send preparation/study material and a reminder email to the participants

Class Location

Street Address

Building/Suite #

City

State

Zip

AV Equipment

Does the room have any existing AV Equipment such as wall mounted TV or projector?

Type of room

Other

Additional Information and Questions

Any additional information that may help in the scheduling process, what type of class you are looking for or questions that you have.

How did you hear about us?

Does your site have an AED?

Please note that submitting this form does not guarantee the class date. EdCor will contact you for scheduling and will send a confirmation when the class is scheduled.