First Aid Training Course - Application Form (Group)

HONG KONG RED CROSS Health & Care Service Department Revised on 10/2013 First Aid Training Course - Application Form (Group) (1) Group Information (Please complete this form in BLOCK LETTERS) Organisation ： (Eng) (Chi) Industry ： Correspondence Address ：

Contact Person ： Mr./Ms./Miss Position： Telephone ： (Company) (Mobile) Fax： Email Address ：

(2) Proposed Course (Please  the appropriate box)  Standard First Aid Certificate Course  Standard First Aid Certificate Refresher Course*  Elementary First Aid Course  Elementary Child First Aid Course  Integrated Cardio Pulmonary Resuscitation Certificate Course  Adult Cardio Pulmonary Resuscitation Certificate Course  Child Cardio Pulmonary Resuscitation Certificate Course  Infant Cardio Pulmonary Resuscitation Certificate Course  Adult Cardio Pulmonary Resuscitation & Automated External  Adult & Child Cardio Pulmonary Resuscitation & Automated Defibrillation Course External Defibrillation Course  Automated External Defibrillation Course*  Youth First Aid Certificate Course

 Automated External Defibrillation Refresher Course*  Domestic Helper First Aid Course  First Aid Talk ______hour (s)  Others: (please specify)

( 3) Medium of Instruction (Please  the appropriate box)  Cantonese  Putonghua  English (4) Course Detailed Information No. of Attendants ： Date(s) ： 1 6 2 7 3 8 4 9 5 10 Time ： From to (Please indicate if every session is different) Venue ：

 HK Red Cross Training Centre (Please refer to the “Application of Rental Service of Training Room”) Exam ination ( if applicable) Date ： Time Venue ：

(5) T raining Equipments Provided by the Group (Please  the appropriate box)  Computer (CD Rom)  Overhead Projector  Projector (link with PC)  Video Recorder  VCD Player  Screen  White Board  Audio Equipment  Towel ______pcs  Mat ______pcs  Car Parking  Shuttle Bus Signature：

Name：

Position：

Date：

Company/Organization’s Chop

Address: Rm 1202, Millennium Trade Centre, 56 Kwai Cheong Road, Kwai Chung, N.T. Tel: 3971 0288 Fax: 3971 0388 Email: [email protected] HONG KONG RED CROSS Health & Care Service Department Revised on 10/2013

Enrolment details Please submit this application form by email (send to [email protected]) or by fax (Fax no. 3971 0388). (* Please provide copies of the relevant certificates if you wish to enroll into Standard First Aid Certificate Refresher Course or Automated External Defibrillation (or Refresher) Course) Enquiry hotline: 3971 0288

Enrolment requirements  Please fill in all information, such as proposed date, time, venue, examination (if applicable), those equipments you can provide, etc.  Please submit this form 6 weeks before the commence date of the course. All trainers are the volunteers of Hong Kong Red Cross with the qualification of First Aid Lecturer or equivalent. We would arrange trainer according to your proposed schedule. However, there are factors affecting the arrangement, such as proposed dates, time, venue, medium of instruction etc. The following are our normal teaching hours: Monday to Sunday and Public Holiday: 0900-1300 1400-1800 1900-2200

 We will inform you by phone for the update status of your application.  For the successful application, we will confirm your application by email with the date, time, detail address and other information.  The formal confirmation letter will be sent out by email around 1 week before the course commenced and other related documents will be attached, such as name list, material order form, manikin loan form (if applicable), student notice, bad weather contingency plan, etc.  If you cannot receive the above information before the course commenced, please contact our staff as soon as possible.  Please submit the name list, material order form, manikin loan form (if applicable) before the designated date.  In general situation, the training materials will be ready 1 working day before the course commenced. Please collect them at our Kwai Chung Office (Unit 1202, Millennium Trade Centre, 56 Kwai Cheong Road, Kwai Chung, N.T.).  Please return all related training materials to our Kwai Chung Office 1 working day after the course completed.  If you cannot collect or return materials on the designated dates, material delivery service can be provided with service charges, please contact our staff for further information.  If the training material were returned after the designated date, a penalty surcharge may be required. This surcharge is HKD$50 per day for each manikin.  After all forms received, we will issue invoice for the payment.  You may settle the payment by separate crossed cheques or in person. Please do not mail us cash or promissory note.  The course fee will not be refunded after settled the payment.  Hong Kong Red Cross Health & Care Service Department reserves the right to change the First Aid lecturer, class schedule and course venue.

Collection of examination result / course certificate  The date for examination result or course certificate collection will be announced to the responsible contact person of organization by email about 1 month after the examination / completion of course. Please bring along the authorization letter or other related document to collect the examination result / course certificate at Kwai Chung Office of Hong Kong

Address: Rm 1202, Millennium Trade Centre, 56 Kwai Cheong Road, Kwai Chung, N.T. Tel: 3971 0288 Fax: 3971 0388 Email: [email protected] HONG KONG RED CROSS Health & Care Service Department Revised on 10/2013 Red Cross Health & Care Service Department in person. You can download the authorization letter from the following website. If you cannot collect it in person, certificate mailing service can be provided with service charge, please contact our staff for more information. (http://www.redcross.org.hk/hcs_faht_files/Certificate%20Collection%20Authorization%20Form_2012E.doc )

Application for change of course schedule  Please provide a schedule which can fit all your participants of your group.  If cancellation or change of schedule is necessary for the confirmed schedule. Please contact our staff in written as soon as possible with clearly stated the reason of cancellation or change, surcharge is required for the change. Please refer to the following table for the details of surcharge. We accept only one time of cancellation of course or change of course schedule.

Notification period Cancellation of course Change of course schedule before the scheduled date of the course Before 30 days 10% of course fee 5% of course fee Less than 30 days 15% of course fee 10% of course fee Less than 14 days 30% of course fee 15% of course fee Less than 7 days 50% of course fee 20% of course fee Course already commenced 100% of course fee HKD$100/ person

Personal information collected through application is only for course enrolment purpose. Applicants have rights to check and change the information with written request. Hong Kong Red Cross Health & Care Service Department reserves the right to amend the above rights.

Address: Rm 1202, Millennium Trade Centre, 56 Kwai Cheong Road, Kwai Chung, N.T. Tel: 3971 0288 Fax: 3971 0388 Email: [email protected]