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Course Evaluation

Use this form to send us feedback about any courses you took and/or course instructors.

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The information you enter below will remain completely confidential. The only two people who will read this information will be the Lifesaving Society Executive Director and the Program Chair on the Board of Directors. We thank you for taking the time to bring concerns to our attention to help us to maintain the highest program quality possible.

Fields prefaced with "*" are required.

* Your Name:
Your E-mail:
Your Phone #:
Course Location:
Course Type (e.g. Bronze Cross):
Course Date(s):
Course Instructor / Examiner:
* Comments: