STOP THE BLEED Class - Community Request Form

STOP THE BLEED Class - Community Request Form

Please complete and submit this form to request a STOP THE BLEED (STB) training from South Metro Fire Rescue.

First and Last Name:*

Email:*

Phone Number:*

Phone

Organization Type:*

If selecting "other", please describe your organization in the Comments section below.

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Requested Class Date (1st choice):*

Please select 2-3 dates that you'd like to host this class. Our team will select one of the dates based on availability. STB Trainings typically run 90-120 minutes long.

Requested Class Date (2nd choice):*

Please select 2-3 dates that you'd like to host this class. Our team will select one of the dates based on availability. STB Trainings typically run 90-120 minutes long.

Requested Class Date (3rd choice):

Please select 2-3 dates that you'd like to host this class. Our team will select one of the dates based on availability. STB Trainings typically run 90-120 minutes long.

Preferred Time Slot(s):*

Please list time slots/range for the dates you selected that you'd like to host this class. Our team will select one of the timeslots based on availability. STB Trainings typically run 90-120 minutes long.

Preferred Location:*

Where would you like this class to be held? Please include an address. You may include more than 1 option.

Multimedia Access:*

Please select all that apply:

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Approximate Number of Attendees:*

Questions, comments, or concerns regarding scheduling:

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