AHA Upload form

CTC Instructor Roster Upload Form

AHA Training Center MA 00633
Section 1- About the class?
Lead Instructor *

First Name Last Name
AHA Instructor ID Number
Instructor Email *
example@example.com
Instructor Status Exp Date *

Month Day Year Date Picker Icon
Instructor Phone Number

Area Code Phone Number
Section 2- Upload your AHA Roster- (Must be current version)
Scan your roster- front & back, and upload it with this link. (Can be .pdf, .jpg, .doc, etc...) *

Browse Files

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Section 3- Select the class type:
Type of AHA Class *

ACLS Provider PALS Provider PEARS BLS Provider ACLS for Exp Providers HeartSaver CPR AED HeartSaver CPR AED with Child CPR HeartSaver CPR AED with Child CPR with Written Exam HeartSaver CPR AED with Child and Infant CPR HeartSaver CPR AED with Child and Infant CPR with Written Exam HeartSaver First Aid HeartSaver First Aid with Exam HeartSaver First Aid CPR/AED HeartSaver First Aid CPR/AED With Exam HeartSaver First Aid CPR/AED With Child CPR HeartSaver First Aid CPR/AED With Child CPR and Exam HeartSaver First Aid CPR/AED With Child and Infant CPR HeartSaver First Aid CPR/AED With Child and Infant CPR with Exam Heartsaver Pediatric First Aid CPR AED Heartsaver Pediatric First Aid CPR AED with Adult CPR HeartSaver K-12 Instructor- BLS (Paper Card) Instructor- ACLS (Paper Card) Instructor- ACLS-EP (Paper Card) Instructor- PALS (Paper Card)
Section 4- Upload Student Data

There are two ways to enter your student data:

Option 1- Manual Data Entry- (Best for small classes)- Enter the class date, first & Last name and the students email address and click "Save, & add student" (After the last student- remember to click "save & add" to save that student)

Option 2- Upload a completed spreadsheet (Blank template availabe below)
Option 1- Manual Data Entry: Enter Student info. (you can not mix class types on one roster. i.e. if you taught a BLS and an ACLS class, you must create 2 electronic rosters.)
OR
Option 2- Upload your Excel spreadsheet

Browse Files

Cancel of
Any notes or comments: (If you are ordering cards for a class that does not yet have eCards- provide a mailing address please)
Section 5- Payment:

HeartSaver eCards are $20.00

HeartSaver K-12 eCards are $10.00- Can be used for Students, Teachers and School Staff certification in primary schools

BLS for Health Care Provider, ACLS or PALS Card are $10.00
(Unless you have a volume contract with the CTC)

Multiply the number of cards requested X your card cost and enter total below.

There are two options for payment:

Option 1- Online credit/debit card payment.

Option 2- Preapproved instructors can be invoiced.

Option 1- Credit Card Payment

USD Enter the amount that you wish to pay

Credit Card Payment
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Option 2- Invoice me

Invoice me (pre-approved instructors only)
Please preview your data, then press submit (If the screen does not advance- scroll up, you most likely omited a required field)
Should be Empty:

CTC Instructor Roster Upload Form