First Aid Coverage Request Form

First Aid Coverage Requisition Form

* Please tick at the appropriate box

Name of the event:

Date:

Time:

from

Venue:

Organised by (name of the club/organisation):

Transportation:

From NTU

Back to NTU

Date

Time:

Venue:

Food provided: *

Breakfast
Lunch
Dinner
Refreshment

Have you attached the programme of your event together with this form? *

Yes No

Do you provide safety vehicle for your event? *

Yes No

If yes, What type of vehicle?

How many participants will betaking part in your event?

How many first aiders do you need for your event?

Please indicate and elaborate the activities/sports that will be held in your event?

Terms and conditions

Please submit this form at least 3 weeks before the event.
NTU Red Cross has the right to reject any incomplete forms or late submission of forms.
Please attach the programme list or awrite-up on the relevant details (eg. running route, the way your event is being conducted) in brief together with this form, otherwise your request will be rejected.
NTU Red Cross can no longer provide ambulance services for future events.
NTU Red Cross has the right to reject all the first aid requests from the club in the future if the club provides incorrect information or breaches the agreement.
The task of the first aiders is to provide first aid service in the event ONLY.
All first aiders have to be provided with chairs and a table labelled as “First Aid Post” in order to be identified easily throughout the event.
Upon completing this form, please click the “Submit” button below, print out the form and get it signed before reaching one of the First Aid Officers to hand it in:

Chen Leru Riodo	+65 8128 4518
Sundar	+65 9427 1674
Wong Chee Keong	+65 8409 0975

Alternatively, you canscan and attach the SIGNED form in an email and send it to redcross-firstaid@ntu.edu.sg.
We will process your request and reply to the person-in-charge within 5 working days.
After submit this form, a comfirmation email with a link to the form you completed will be sent to your mailbox, you will be able to access this form and print it out this form later.

I have read and understood fully of the terms and conditions stated above

I will be the person who liasies with the NTU Red Cross for the event stated above from now untill the end of the event.
If not please fill in the person's particulars below:

Name:
Matriculation Number (only for NTU student):
Contact Number:
Email Address:

Requested by,
Name:
Matriculation Number(Only for NTU students):
Contact Number:
Email Address:
Date: