There are more than 356,000 out-of-hospital cardiac arrests annually in the U.S. Between 60-80% of them die before reaching a hospital. CPR, especially if administered immediately after cardiac arrest, can double or triple a person’s chance of survival.

AED Grant Application

The Ohio CPR Certs Fund strives to place AED units in locations where the risk of cardiac arrest is high. Priority is given to non-profit organizations that serve adults or youth, athletes, churches, scouting, and other community focused organizations. This program is meant to target non-profits that usually do not have funding to purchase this lifesaving equipment but serve many people! Our donation area targets the geographic region of Central Ohio. Central Ohio consists of the counties of Franklin, Delaware, Union, Madison, Pickaway, Fairfield, Licking and Knox. Unfortunately, we are unable to donate to organizations outside of those counties.

Organization Name

Are you located in Central Ohio?

Yes

What type of organization are you?

Are you a registered 501(c)3 Non-Profit Organization?

Yes

If yes, what is your EIN?

How did you hear about us?

Organization Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Contact Information

First Name

Last Name

Primary Contact Title

Primary Contact Email Address

Primary Contact Phone

(###)

###

####

Organization Website

http://

The Ohio CPR Certs Fund seeks to support non-profit organizations that serve adults, children, youth groups or athletes. Of particular interest is organizations that do not have an AED device already.

Do you currently have an AED device?

If yes, what is the brand and approximate age of the device?

How many people (unduplicated adults and children) does your organization serve on an annual basis?

How many children does your organization serve, if applicable?

How many staff/volunteers are currently trained in CPR/AED?

Why is your organization requesting support for an AED? Use this area to provide a summary to your request, your need, and information we should know about your organization.

Your organization must have individuals trained in CPR/AED. Ohio CPR Certs offers CPR and AED training courses, along with many other trainers in Central Ohio, if you don't already have people trained. We also recommend that an Emergency Action Plan (EAP) is developed and posted near your AED. It is also important to have an AED inspection/check procedure written and followed to ensure the device will always be ready to rescue.

Will you be able to setup an AED program (have staff trained in CPR/AED, an AED maintenance/check procedure, Emergency Action Plan)?

Who from your organization will be responsible for the monthly/quarterly inspections and maintenance of the AED?

Who will be responsible for registering the AED with the manufacturer and with local EMS?

Quick access to the AED is crucial to the efficacy of the chain of survival. The AED should be located where it is highly visible and immediately accessible to trained lay responders and the general public.

Where do you plan to place the AED so that it is accessible to potential responders/public?

Will the AED be placed indoors or outdoors?

Raising awareness for CPR/AED training is important. Sudden Cardiac Arrest (SCA) is the leading cause of death on school campuses, and the #1 killer of student athletes.

How will you promote the importance of training to your community?

How will your organization promote this AED Grant Award to your community?

Do you have a meeting or a special time that you would like to receive the AED donation?

By submitting this application, you acknowledge that all information contained herein is true and correct on the date of submission and that you are authorized to submit an AED Donation Application on behalf of your organization.

Yes

You grant the Ohio CPR Certs Fund a license to use, reproduce, transmit, distribute and display your AED Donation Application and all information and content in the Application in connection with the Fund’s activities, including, without limitation, publicizing awards and its programs generally on its website or in other media. Further, you agree to a photo opportunity at time of delivery/install of the AED, and any publication or promotion publicizing the event.

Yes

Do you fully understand that an expired battery and/ or expired defibrillation pads for the AED will not permit proper function or use of the device? Further, you agree to maintain the AED according to manufacturer guidelines, including regular inspections, accessory replacement, and repairs as required?

Yes