Instructor Records Transfer Request

Instructions:  When an instructor wants to transfer to a different Training Center (TC), this form must be completed by the instructor, the transferring TC Coordinator (TCC) and the accepting TCC.  The transferring TCC returns the completed form with the instructor's records to the accepting TCC.  The accepting TCC contacts the instructor when the transfer is complete.

SECTION 1: 

We agree to keep and maintain all instructor records in accordance with our TC Agreement with the AHA and the Program Administration Manual.  Below provide your CURRENT TC's information.

SECTION 2:

I,

authorize the transfer of my instructor records.

Which disciplines are you current in your certifications? Check all that apply.

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