For MMRTAC Instructors to enter data from stop the bleed classes of any type.

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1. Date of Class

Date

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2. Duration of Class (in hours)

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3. Instructor 1 Name- First and Last

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4. Sponsoring Agency (i.e. Hospital, EMS , FD, PD, Etc.)

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5. Instructor 2 Name- First and Last

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6. Location of the class

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7. Location- City

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8. Number of Participants

T