Type contact information below (we need this done every year to assure we have the most recent information). Date * Month 1 2 3 4 5 6 7 8 9 10 11 12 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Full Name * Address
* Email *
Mobile Phone * Other Phone I agree to uphold the mission statement of ASM *
1. The mission of Accident Scene Management (ASM) is to reduce injuries and fatalities associated with motorcycle crashes through First Response education. ASM’s goals associated with that mission are to provide quality Bystander Assistance Programs (BAP) in order to strengthen the Emergency Medical System (EMS) and its effectiveness. We also intend to strengthen the EMS in its response to motorcycle trauma.
Level One: I agree to provide a copy of my Professional license to ASM. Furthermore I agree to keep this certification current and provide copies in a timely manner when requested. *
2. In order to maintain this focus it is imperative that ASM classes be taught by individuals who are qualified to teach this medically oriented material. It is also important that instructors understand anatomy as well as the EMS system and how it works. We always seek instructors who are love to teach. ASM has Two Tiers of Instructors. Lead instructors (Level One) must be EMT or higher in medical training and a motorcyclist or have been approved to advance from Level Two to Level One (see process in the Instructor Binder). Level Two instructors must be a motorcyclist but do not need a medical background. A Level Two Instructor can also be a medical professional who does not ride motorcycle. A Level One (Lead) Instructor must be present for the duration of every class and may teach a class alone. A Level Two instructor can teach any portion of the program (no restrictions but must have a Lead instructor present and cannot teach a class alone.
Level Two: I agree not to teach ASM classes without a Lead instructor present for the duration of the class. I agree to be responsible for the use of any course assistant and to be sure that they are properly trained if asked to assist with hands on skills *
3. Course Assistants may be used to assist with larger classes. They can assist with registration, class logistics, assist you with AV and hands on but they cannot teach! Course Assistants are not recognized by ASM as instructors. If they assist with Hands on, it becomes the responsibility of the Lead instructor to be sure they know what they are doing. If there are any issues that arise due to the use of a Course Assistant, the Lead instructor will be held responsible.
I agree to have one instructor/assistant for every 20 students *
4. More students trained is better! ASM recognizes that the difficulty in training more people is mainly logistics including hands on (lecture may be done to large groups) In order to provide a quality experience for your students an additional instructor or an course assistant should be used for groups larger than 20.
I agree to abide by all terms set forth re: raising funds for ASM and if in doubt or uncertain about terms set forth, will contact ASM for clarification. *
5. Funds may be raised for your program and its development. If you are planning a fundraiser or approaching a group about having a fundraiser and are using the ASM name to raise those funds, ASM must be consulted and notified. If a group makes a donation by writing a check to ASM, that check must be sent to ASM. You may request to use those funds (less 10% minimum donation back to ASM) to further training in your area but all funds donated must be accounted for. Tax-deductible receipts may not be issued if ASM does not know about the donation. All items donated to ASM are the property of ASM. If you discontinue teaching, all items must be returned to ASM to be redistributed to other instructors so they can use those items to further ASM’s cause.
I agree not to issue tax deducible donation forms without notifying ASM within 10 days of receipt of the item or funds * I agree to teach rescue breathing as currently recommended by the AHA *
6. ASM maintains its own curriculum and standards based upon the US DOT Emergency Medical Responder Curriculum, American Academy of Orthopedic Surgeon’s helmet removal technique and American Heart Association Jaw Thrust Technique for spinal preservation. Instructors must follow ASM’s curriculum and must not add other techniques or topics. This includes not adding videos or pictures to the ASM PowerPoint Program without permission. Instructors must not alter or mix programs. In other words, if you are teaching “A Crash Course for the Motorcyclist” you should not add slides from “Anatomy of a Motorcycle Crash” or visa versa. Instructors who do not follow these guidelines will face discipline or possible revocation of their license to teach ASM programs.
I agree to teach full faced helmet removal as recommended by the American Academy of Orthopedic Surgeons. * I agree NOT to teach full faced helmet removal without also teaching jaw thrust rescue breathing. * I agree to use ASM literature at all classes taught using the ASM name *
7. ASM classes are recognizable for their standard content. In order for a class to be recognized as an ASM class, ASM materials (student packets and Power Point) must be used. The class that is taught in Florida should be the same class that is taught in Alaska. While we encourage instructors to use stories and to have fun with their students, content must not change. A full student packet must be issued to each student that includes their certificate of completion and their patch. Students will only get credit (certificate and patch) for completing the entire 100 or 300 series class. Patches may not be purchased unless the class has been completed.
I agree to issue ASM Certificates and patches to those who have completed the entire ASM class and will not issue a certificate and patch to those who have not completed the entire class. * I agree to register all classes with ASM *
8. Students frequently contact the ASM office asking about classes. They also look for instructors who are actively teaching. ASM must be notified of all classes that are being taught using the ASM name as soon as you have enough information (Date, time, student charge, basic location) to be able to register the class. Classes will be posted within three days of receipt.
I agree to provide an evaluation summary after each class to ASM within 30 days after each class that is offered. *
9. One of the things that cause the ASM organization to be special is that we track students. We can tell those who inquire; who is teaching our program, how many classes have been taught, how many students have been taught and how our programs have been evaluated by students. Instructors are required to provide the following in a timely manner. ASM also issues continuing education credits and is mandated by the credentialing organization to keep records of students to include Name, address & phone and/or email. ASM prefers e-mail (phone is for you to call the student if there is a last minute change of plans for the class or question).
I agree to answer all inquiries referred to me within 3 days (72 hrs) of receiving the request * I agree to provide a class roster with a minimum of the full name, address and email address of students within 30 days after the class has been held. * I agree to teach two classes a year to maintain my “active” instructor status. *
10. An instructor gets better at teaching as they teach classes. It is important to teach at least two times a year in order to have a degree of comfort with the material. Of course more is always better! Active instructors are those who teach two or more a year. If an instructor is “inactive” for two years in a row they may be contacted to determine what their desire is re: continuing to teach and affiliate with ASM
I agree to keep my focus on ASM topics only while representing ASM and when pressed for my personal opinion will refer the requester to the ASM office or claim NO COMMENT. *
11. Instructors may have strong opinions about matters that are not ASM First Response Curriculum related. As an educational non-profit organization, ASM instructors must refrain from speaking to press or students about matters not ASM related during classes or while representing the ASM program. This includes but is not limited to politics & religion. Regarding laws ASM recommends students obey current laws and beyond that has NO COMMENT.
I agree to contact ASM if a business or group requests to affiliate with ASM *
12. Organizational affiliations can be a good or a bad thing. All official affiliations must go through ASM’s BOD. Please contact ASM if you receive a request such as this.
I agree to support ASM’s agreements with corporate partners/sponsors *
13. Anyone contacting you wishing to speak to your group of students will require a call to the ASM office before proceeding. Your respect and assistance in maintaining these contractual agreements are imperative as they make it possible to provide you with active web services, curriculum and a staff to serve you.
I agree to pay a yearly fee to maintain my license, ASM services & Road Guardian Membership *
14. ASM makes a commitment to its instructors. ASM agrees to make a continuous effort to be available for guidance and to keep instructor materials & website updated as needed. In order to accomplish this, a yearly fee is assessed to maintain and update records as well as website information. This service is included in your initial instructor packet and then becomes due March 31st each year. The 2015-16 fee is $35.00 and includes Road Guardians Membership. Instructors can determine that they would like to donate additional tax-deductible amounts to the ASM organization or work with ASM to host a fundraiser that benefits your local program as well as the home office but we recognize that your donation is often that of the front line worker.
I agree to answer ASM inquiries within 3 days or refer the request to the ASM office *
15. Potential class hosts and students often visit the website and look for instructors, contacting them via their online information. It is important to check your email regularly and answer any inquiries in a timely manner (within 72 hours/3 days).
I agree to notify ASM of any contact information changes in a timely manner * 16. I understand that the above terms pertain to all ASM instructors. I understand that the above terms are not a comprehensive list of all terms set forth by ASM and that when I am in doubt of a policy or procedure I should contact ASM for guidance. I understand that my behavior can reflect on the organization that I am representing and therefore agree to interact in a professional manner. I understand that my continued use of the ASM brand is contingent upon my adherence to these and all other ASM terms. I understand that I will lose my right to use the ASM brand, including teaching ASM classes, if I fail to follow all terms set forth by ASM. I understand that ASM has the authority to terminate my license to use the ASM brand without notice to me if I fail to abide by any and all of the terms set forth by ASM. I understand the terms stated above and I agree to be bound by them. *