General Information
Name
*
First Name
Last Name
Email
*
example@example.com
Are you completing this form on behalf of a district or school?
*
District
School
School Name
*
District Name
*
Location
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Number of schools in your district
*
Number of teachers and staff in the district
*
Number of staff on campus
*
How many students does your district serve?
*
How many students are there at your school?
*
Do you know what an Automatic External Defibrillator (AED) is?
*
Yes
No
Automated External Defibrillator
An AED, or automated external defibrillator, is used to help those experiencing sudden cardiac arrest. It's a sophisticated, yet easy-to-use, medical device that can analyze the heart's rhythm and, if necessary, deliver an electrical shock, or defibrillation, to help the heart re-establish an effective rhythm.
Are there any AEDs on your campus(es)?
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Yes
No
Does each school in the district have an AED?
*
Yes
No
If "No" which school(s) in your district are
without
AEDs?
*
How many AED devices are on campus?
*
How many AED devices are on campus? (Please list each school and number of AEDs)
*
How many AEDs are expired?
*
Where are the AEDs located? (Select all that apply)
*
Gym
Football/Sports Field
Cafeteria
Nurse's Office
Other (Please Specify)
Please select the reason(s) for not having an AED on campus (Select all that apply)
*
Too expensive
We are not required to have one
No staff is trained
Not needed
Other
Are staff members trained in using an AED?
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Yes, ALL staff members are trained
Yes, but ONLY the nursing staff are trained
Yes, but ONLY SOME staff members are trained
No, training IS NOT required for staff members
I don't know if there is staff trained or not
Are staff members trained in providing CPR?
*
Yes, ALL staff members are trained
Yes, but ONLY SOME staff members are trained
No, training IS NOT required for staff members
I don't know if there is staff trained or not
Are the AEDs regularly inspected?
*
Yes
No
Unknown
Please select which athletics programs are at your school (Select all that apply)
*
Football
Baseball/Softball
Basketball
Track & Field/Cross Country
Tennis/Racquet sports
Swimming/Diving
Wrestling
Soccer
Lacrosse/field hockey
Gymnastics
Other
Which Athletics Facilities do you have on campus? (Select all that apply)
*
Gymnasium/Basketball Arena
Football Field
Auxiliary Gymnasium
Weight Room
Baseball/Softball Fields
Track
Tennis Courts
Swimming Pool
Other
If "Other" please describe the additional Athletics Facilities your campus has
*
AED Assistance Program Overview
Selected participants will go through two training sessions (2.25 hour training / 8 hour training) for AED usage and training additional staff on AED usage. After trainings have been completed (in July ahead of new school year) the Fiesta Sports Foundation in partnership with BHHS Legacy Foundation will return for a donation ceremony (early August) to officially donate the AEDs.
If chosen to participate, there will be two trainings for selected staff members to participate in. These trainings need to be completed in July, 2026. Can you commit to completing these trainings in before August, 2026?
*
Yes
No
If chosen to participate, there is pre coursework required for all participants; an online portion before basic and an online portion before instructor. Can each participant commit to completing the online course work PRIOR to both in person trainings?
*
Yes
No
If you are selected for this program, will you secure your superintendent's permission to participate?
*
Yes
No
Submit
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