(Organization s Name)



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2 1 6 W A K E M A N P L A C E B R O O K L Y N, N E W Y O R K 1 1 2 2 0 W W W. A F O R U M F O R L I F E. O R G P H O N E 7 1 8 7 5 9 9 0 1 3 F A X 4 3 7 4 9 7 4 0 2 9 In association with the PROPOSAL FIRST RESPONDER INSTRUCTOR CERTIFICATION FOR (Organization s Name)

PROJECT SCOPE MISSION STATEMENT A FORUM FOR LIFE, INC. is 501(C)(3) New York Corporation. Our organization provides professional development under the New York State Department of Education. Our organization operates as a model for human growth, learning, diversity, and the personal development of students, staff, community bases organizations as well as the private sector. The LIFE motto, Live Is Fulfilling through Education, expresses the impetus within each component of our Forum, few being more fundamental than health and safety. We propose to engage in First Responder Certification Training for those referred by. PURPOSE The primary purpose of the program is to provide student-centered services which focus on Medical Emergency Response Certification. For the enhancement of the students whom we serve and our professions, we also engage in training and scholarly research activities as an integral part of our role within Greater New York. PROJECT SCOPE A Forum for LIFE, Inc., a nonprofit Corporation, is a recognized training center for the Emergency Care and Safety Institute (ECSI), the American Academy of Orthopaedic Surgeons (AAOS) and American College of Emergency Physicians (ACEP). Our pubic charity will support 50% the cost of training participants referred by. Since the inception of our mission statement in 2004, A Forum for LIFE, Inc. has provided various health & safety certification, lectures and workshops to over 211,000 individuals in Greater New York. The majority of these participants have an association with us via Community Partnerships with large organizations such as the Administration for Children s Services, the New York City s Department of Health & Mental Hygiene, the Department of Homeless Services, the Department of Youth & Community Development and Catholic Charities. 2

C O M P O N E N T S O F P H A S E I B A S I C T R A I N I N G A Forum for LIFE, Inc. shall deliver the following training components beginning with Phase I, which includes: 1. Pediatric, Child & Adult CPR Background Information Action at an Emergency Finding Out What s Wrong CPR 2. Automated External Defibrillator An automated external defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, [1] and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm. AEDs are designed to be simple to use for the layman, and the use of AEDs is taught in many first aid, first responder and basic life support (BLS) level CPR classes. 3. Standard First Aid Bleeding and Wounds Shock & Burns Head and Spinal Injuries Chest, Abdominal, and Pelvic Injuries Bone, Joint, and Muscle Injuries Poisoning Bites and Stings Sudden Illnesses Heat- and Cold-Related Emergencies Rescuing and Moving Casualties A FORUM FOR LIFE IS A NOT-FOR-PROFIT CORPORATION & PUBLIC CHARITY. 3

P H A S E I I A D VA N C E D T R A I N I N G 4. Blood-borne Pathogens (Prevention of Disease Transmission) This program provides training about the risks and hazards associated with the tasks involving blood and Other Potentially Infectious Materials (OPIM). Despite the advances in engineering work practices, and personal protective equipment, the health risks posed by handling of blood and OPIM remain very high. The requirements of the OSHA Blood-borne Pathogens Standard continue to be essential in maintaining safe work environments for all employees engaged in handling blood and OPIM. 5. Oxygen Administration Providing supplemental oxygen to those that need it is an essential element of emergency care. Oxygen Administration is designed to provide an understanding of how to safely handle and administer oxygen in various settings. Key topics discussed in the Oxygen Administration course include: The components that make up a supplemental oxygen system. The various types of supplemental oxygen devices. Important safety, storage, service, and maintenance steps regarding the use of supplemental oxygen systems. The importance of supplemental oxygen in the care of victims of sudden illness or injury. Using supplemental oxygen equipment when providing care for a breathing or non-breathing victim. 6. Advanced First Aid This training component provides information on how to handle common injuries and illnesses when medical care is an hour away or more. Designed for those who work or travel in remote locations, this comprehensive guide will teach you what to look for and what to do in the event of an emergency, and direct you to the most appropriate type of care. Completely revised, the Third Edition contains updated information on first aid training and complies with current cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) guidelines. 7. CPR for the Professional Rescuer This training component provides individuals who have a job-related duty to respond to emergencies with the knowledge and skills to recognize and provide care in respiratory and cardiac emergencies. These skills include: 4

Performing two-rescuer CPR and techniques for special rescue situations. Using resuscitation masks and bag-valve masks for ventilating victims. Proper use of an Automated External Defibrillator (AED). P H A S E I I I F I R S T R E S P O N D E R C E R R T I F I C A T I O N Phase III fully integrates the most current CPR and ECC guidelines and includes new chapters on: Communications and Documentation Geriatric Emergencies Terrorism Awareness Designed to meet the needs of law enforcement personnel, fire fighters, rescue squad personnel, athletic trainers, college students, and laypersons, the new features found in our Fourth Edition will help students take the next step toward becoming outstanding First Responders. These features include: Endorsement by the American Academy of Orthopaedic Surgeons You are the Provider, attention-grabbing case studies found in every chapter Special Population Tips, discussing the specific needs and emergency care of special populations, including pediatric, geriatric, and special needs patients Enhanced skill drills First Responder Practical Skills Review Table of Contents Section 1. Preparing to Be a First Responder Chapter 1. Introduction to the EMS System Chapter 2. The Well-Being of the First Responder Chapter 3. Medical, Legal, and Ethical Issues Chapter 4. The Human Body Chapter 5. Lifting and Moving Patients Section 2. Airway Chapter 6. Airway Management Section 3. Patient Assessment Chapter 7. Patient Assessment Chapter 8. Communications and Documentation Section 4. Circulation Chapter 9. Professional Rescuer CPR A FORUM FOR LIFE IS A NOT-FOR-PROFIT CORPORATION & PUBLIC CHARITY. 5

Section 5. Illness and Injury Chapter 10. Medical Emergencies Chapter 11. Poisoning and Substance Abuse Chapter 12. Behavioral Emergencies Chapter 13. Bleeding, Shock, and Soft-Tissue Injuries Chapter 14. Injuries to Muscles and Bones Section 6. Childbirth, Pediatrics, and Geriatrics Chapter 15. Childbirth Chapter 16. Pediatric Emergencies Chapter 17. Geriatric Emergencies Section 7. EMS Operations Chapter 18. EMS Operations Chapter 19. Terrorism Awareness Section 8. Enrichment Chapter 20. Special Rescue Chapter 21. Supplemental Skills IN-KIND CONTRIBUTION TOWARD COSTS In these trying financial times here are ways that we save people money while delivering invaluable emergency response training programs: 1. We will supply all manuals, materials, audio-visual equipment and certificates. 2. We shall accommodate groups of ten or more at your location. 3. A Forum for LIFE shall provide 50% of all cost, as In-Kind support to. Certificates will be presented upon completion of each component. 4. All re-certifications will be presented free of cost as an additional In-Kind contribution from, A Forum for LIFE, Inc. to. THE BOTTOM LINE 6

PHASE I DONATION - $125.00 PER PERSON COURSE LIST AVERAGE COST YOUR DONATION Standard First Aid Certificates are valid for three years Pediatric, Child & Adult CPR Certificates are valid for two years Automated External Defibrillator Certificates valid for two years CPR Kits $90 per person 4 hours $100 per person 4 hours $44 per person 2 hours $22 each $45.00 per person $50.00 per person $20.00 per person $10 each Phase II Donation - $280.00 per person TRAINING COMPONENT AVERAGE COST YOUR DONATION CPR for the Professional eight hours Two year certification Advanced First Aid sixteen hours Three year certification Blood-borne Pathogens 4 hrs One year certification Oxygen Administration 4 hrs One year certification $130 per person $80 per person $185 per person $100 per person $100 per person $50 per person $100 per person $50 per person A FORUM FOR LIFE IS A NOT-FOR-PROFIT CORPORATION & PUBLIC CHARITY. 7

Phase III Donation - $1,100 per person TRAINING COMPONENT AVERAGE COST YOUR DONATION First Responder eighty hours Three year certification $2,200 per person $1,1000 per person Executive Summary Whether you're new to the world of work, making a transition, taking a new direction, or simply feeling the need for a change, what you're really doing is growing. Even though it's a natural part of life, change can be difficult. A Forum for LIFE, Inc. is here to be of service. Life includes trauma and very difficult times for most people. We are offer important and objective support through the invaluable training described within this proposal. While focusing on the development of life-saving skills as First Responder Certification, our concerned staff and administration will; Identify transferable and marketable skills Functional resume development Techniques for expanding a professional network Development of letters of introduction and contact Job interview skills Salary negotiation strategies Creating new or expanded job position and Provide ongoing counseling support and consultation for each participant. Assisting individual students with realizing their unique potential is the core mission at A Forum for LIFE, Inc. This life-affirming training program is a prime example of how we help people in order to help others, in other words, Life Is Fulfilling through Education. 8

ENDORSEMENT IN WITNESS WHEREOF, the Parties execute this Agreement intending to be legally bound, followed by spaces for names, dates and signatures of each party. A Forum for LIFE, Inc. Consultant Client Chief Executive Officer Executive Director November 4, 2012 November 4, 2012 A Forum for LIFE, Inc. is a 501 C 3 New York Public Charity and all donations are Tax-Deductible to the extent the law allows. A FORUM FOR LIFE IS A NOT-FOR-PROFIT CORPORATION & PUBLIC CHARITY. 9