AHA ACLS Course
AHA ACLS - External Student Registration Form
Dear Candidate,
Thank you for choosing to enroll for training with the Life Support Training (LiST) Department, SCOPE.
To register for course training please fill out the form below:
Note:
ACLS is a two day Course.
Shifa LiST Center registration process works on FIFO Method (First in First Out).
"Once the fee is submitted, there will be no refunds"
This Registrations form is for external (Non Shifa) participants only
Certificates will be issued under the spelling provided here
Please mention your Department and Organization
Please mention your area of specialty
Please mention your current year of medical education E.g. PG I, PG II, PG III, PG IV or Year of Graduation
Please provide your CNIC number
Please provide your mailing address
AHA ACLS Course Fee is PKR 28,000/- (Twenty Eight thousand only)
All payments must be deposited at:
Title of Account: Shifa Foundation
Bank: Allied Bank Limited
Branch: I–8 Markaz, Islamabad (Branch Code 0947)
Account No.(From other banks): 0947–0010008262400015
Account No.(From Allied bank): 0010008262400015
IBAN: PK72 ABPA 0010008262400015
Swift Code: ABPA PKKA AHA
AHA Disclaimer:
" The American Heart Association strongly promotes knowledge and proficiency in all AHA courses and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the AHA. Any fees charged for such a course, except for a portion of fees needed for AHA course materials, do not represent income to the AHA."
Please enter your transaction reference number
Attachments are required:
I attest that the information given above is correct to the best of my knowledge and allow Life Support Training (LiST) department, SCOPE to use the above mentioned information to contact me.
Ticking the checkbox below is to be considered the equivalent of my signature and consent for the above.