<p> Training Center</p><p>Card Security Form</p><p>Each student who successfully completes an AHA ECC Course must be issued the appropriate course card that bears the AHA logo. Course completion cards must be issued within 20 business days of receipt of the course completion, although all cards should be in the students’ hands as quickly as possible. </p><p>As an instructor aligned with UnityPoint Health – Des Moines TC:</p><p>1. I will be responsible for tracking each AHA card that I purchase. I will keep the cards under lock and key. </p><p>2. I will comply with the UnityPoint Health –Des Moines TC Course Card Management Policy.</p><p>3. I will not change the AHA cards in any way. I will not create my own card or certificate in place of the official AHA card.</p><p>I have read and will comply with the above information given in this release form. If I fail to comply with the above guidelines, I realize my alignment with the UnityPoint Health –Des Moines TC can be terminated.</p><p>Signed by ______Date ______</p><p>Name Printed ______SS# ______</p><p>Address ______Phone # ______</p><p>City, State, Zip Code ______</p><p>E-mail address ______</p><p>D:\Docs\2017-12-14\0683e3492005619742a53ff607e9744b.doc 2013</p>