WASHINGTON TOWNSHIP FIRE DEPARTMENT

AHA Training Site Affiliation Agreement

Complete, review, and electronically sign the affiliation agreement.

Training Site Details

Organization / Training Site nameTraining Site CoordinatorTraining Site addressAuthorized representativeRepresentative titleEmail for signed copy

Authorized course disciplines (select applicable)

Agreement Terms

Read the full terms before signing. A complete copy will be included in your signed PDF.

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I have reviewed and agree to the full agreement above. I acknowledge the insurance requirements and that Training Center insurance does not extend to our Training Site. I am authorized to sign on behalf of the Training Site and consent to electronic signing and delivery.

Electronic Signature

Sign using your mouse, finger, or stylus.

The Training Center representative signature of Jason Hartley, Deputy Fire Chief, will be applied automatically after submission.