Requesting AED's

If your business or organization would like to be considered as a recipient of one of our AEDs please complete the form below. We will review your information and determine if your needs meets our requirements. We would like to get as many AEDs out in the community but we have received many requests and are trying to get our AEDs out to places that will benefit the most people and meet the needs of the locations. Filling out this form will not guarantee you an AED. However, if we can't get you one this year, we will place you on a list for next year. Our mission is to get AEDs to every place that requests one! 

Please fill out the from Below!!!!