Invoice Concordia Nursing Roster

Invoice Carmen at Concordia Roster

Roster form to record training for Concordia Nursing & Health employees. TS should invoice Carmen Solano for these cert. cards.

Roster Instructions

An instructor agreement with the Training Site must be in place to use this roster.

Instructors must retain original course roster (with students\’ name/signature) and other course records (exams, evaluations, skill check forms) for 3 years. Course records are subject to inspection by the Training Site, Training Center, or AHA faculty.

No fee for \”File Only\” rosters. Please verify spelling of student names.

Roster Information

Lead Instructor: *

Instructor E-mail: *

Instructor Phone: *

Course Taught: *

Course Type: *

Initial Classroom

Renewal Classroom

Online Skills Session only

Course Location: Concordia Nursing & Health *

Assisting Instructors (if any): *

Student to Manikin Ratio: *

Class Date: *

Class Start Time *

Class Length (hours): *

Student names. Place comma after each name, and exam scores for BLS. *

Are certification e-Cards needed? *

Yes

(If cards are Not needed, then go to bottom and \"Submit\" roster).

Payment/Mailing Instructions:

If e-Cards are needed, please include delivery information and payment method.

Payment Method: *

n/a - e-Cards were emailed to students by TS

n/a - e-Cards were emailed to students by instructor

Yes, e-Cards need to be sent

Invoice Carmen at Concordia

By submitting, I verify this course was taught following the current AHA guidelines, using course video and other AHA Instructor support material, and Concordia should be billed for cert. cards.