PALS, PEARS, ACLS, and BLS "*" indicates required fields Which training would you like to attend*Please pick PALS, ACLS or PEARS. Remember you can add BLS to stay current. All advanced courses require a current BLS certification. Pediatric Advanced Life Support (PALS) Pediatric Emergency Assessment, Recognition and Stabilization (PEARS) Advanced Cardiovascular Life Support (ACLS) PALS Provider Course or Update Course*You require a 2-day Provider course if it is your first time or if you have expired. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* Provider Course Update Course PEARS Provider Course*BCH only offers a PEARS Provider course. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* Provider Course ACLS Provider Course or Update Course*You require a 2-day Provider course if it is your first time or if you have expired. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* Provider Course Update Course Training Dates - PALS Provider Course*You are required to look for an update course within the month you expire. Please choose multiple dates that you are available to attend. Supplying multiple choices allow us to seat you more efficiently without delay. Please note PALS Provider courses through August have filled to capacity. You can call 617-355-2649 to be added to a waitlist. September course dates will be added to this form on or about May 1, 2025. Training Dates - PALS Update Course*You are required to look for an update course within the month you expire. You can only choose a date prior to your current expiration date. Please choose multiple dates that you are available to attend. Supplying multiple choices allow us to seat you more efficiently without delay. June 23, 2025 July 10, 2025 July 16, 2025- Waltham July 30, 2025 August 8, 2025 August 20, 2025 - Waltham PEARS Provider*You are required to look for an update course within the month you expire. Please choose multiple dates that you are available to attend. Supplying multiple choices allow us to seat you more efficiently without delay. Please note PEARS courses through August have filled to capacity. You can call 617-355-2649 to be added to a waitlist. September course dates will be added to this form on or about May 1, 2025. Select AllTraining Dates- ACLS Provider Course*You are required to look for an update course within the month you expire. Please choose multiple dates that you are available to attend. Supplying multiple choices allow us to seat you more efficiently without delay. July 1 & 2, 2025 August 6 & 7, 2025 Training Dates - ACLS Update Course*You are required to look for an update course within the month you expire. You can only choose a date prior to your current expiration date. Please choose multiple dates that you are available to attend. Supplying multiple choices allow us to seat you more efficiently without delay. April 17, 2025 - Waltham May 27, 2025 June 17, 2025 - Waltham July 17, 2025 - Waltham August 5, 2025 August 21, 2025 - Waltham This field is hidden when viewing the formCourse LocationAll courses are held in Boston unless otherwise noted beside the date you are choosing. Boston Waltham Name*As you would like it to appear on card First Last RN, MD, PNP, Other:*Are you a Boston Children's employee or affiliate?* Yes No Status (employees only)* Full time Part time (covered by dept of nursing if you have a reg 20hr. schedule) Per diem (not covered by dept of nursing) Travel (not covered by dept of nursing) Email*This office will only respond to your professional BCH email address, if you have had a recent name change please make sure to use the correct BCH email address. Phone*Home Address (business addresses are not accepted)* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Do you require BLS CPR with your course?*Any nurse with an expired or soon to expire BLS certificate will automatically be issued an American Heart Association part one Heartcode BLS online test and be expected to complete it to test out skills in their scheduled advanced course. Yes No BCH Employee ID #*Department name*Special Instructions. This is a free text field.Will your department be covering the cost?*If you are a Per Diem, travel, or a Part time nurse working less than 20 hrs. a week you must cover the cost of your course. To submit payment please call the office at 617-355-26449 (or ext. 52649). We are unable to seat you until payment has been secured. Yes No Payment - Department ID# and Approving Managers name*Not required for RNs/APNs (your dept. ID is on file). For others (MDs, PAs, RRT, etc.), we are unable to process without numerical number and approver name.PaymentFor security purposes; before registration can be processed self-paying participants must contact the office 617-355-2649 during normal business hours Monday through Friday 7:00am- 3:30pm to make paymentPhoneThis field is for validation purposes and should be left unchanged. Δ