DONATE

Consider making a recurring tax-deductible donation. Know, thatthroughyoursupport,youareamongthosewhosevisionandpassionwillkeeptheparamedicroleincriticalcaretransportvibrantnowandfor generations to come. Also consider the THF in your estateplanning!

RecurringPaymentAuthorizationFormI ____________________________ authorize The Tim HynesFoundationtochargemycreditcardindicatedbelowfor$_____each month as a tax-deductible donation to support THFactivities.BillingAddress Phone# City,State,Zip Email

�Visa �MasterCard�AmexCardholderName AccountNumber Exp.Date SIGNATURE DATE IunderstandthatthisauthorizationwillremainineffectuntilIcancelitinwritingatleast15dayspriortothenextbillingdate.IcertifythatIamanauthorizeduserofthiscreditcardaccountandwillnotdispute thesescheduled transactionswithmy bank orcreditcard company; so long as the transactions correspond to the terms indicated in thisauthorizationform.

Tim Hynes Foundation 4835 Riveredge Cove • Snellville, GA 30039

770-979-6372 • www.timhynesfoundation.org

Safety Management

Training Academy SCHOLARSHIP PROGRAM

Submission deadline: Dec. 31, 2016 Recipient will be announced at CCTMC in April Questions? Contact John Clark at 678.368.4970

WhatisSMTA? ScholarshipEligibility

Safety Management Training Academy (SMTA) is a robusttrainingprogramonsafetymanagementfortheairmedicaland critical care community. The program provides acomprehensivefoundationin thescienceandapplicationofthe discipline of safety systems for current and futureleadersinemergencymedicaltransport.

GraduatesReceive• SMTACertificateof Instructionverifyingcompletionofthe

coursecontent• U.S.DOTTransportationSafetyInstitute(TSI)Risk-Manager

TrainerCertificate• OSHA Training and ‘wallet card’ verifying completion of

coursecontenttaughtbyOSHAauthorizedinstructors• Eligibility to sit for the Certified Medical Transportation

SafetyProfessional(MTSP-C)SpecialtyCertificationExam

ScholarshipTermsThe THF will provide the scholarship funding directly to theSMTA training facility, in the amount of a double roompackage. This package includes five nights lodging, breakfastand lunch Monday through Thursday, Sunday eveningreception/dinner,ThursdayeveningGraduationBanquet,andacontinental go-tobreakfastonFridaymorning. Also includedin the scholarship amount is the cost of all classes,monographs,studymaterialsandcoffeebreaks.

TheTHFBoardofDirectorswillreviewallqualifiedapplicationsanddeterminethescholarshiprecipient.

Criteria

1. Actively involved, in a full-time capacity, in medicaltransport as either an aviation or healthcare relatedprofessional.

2. Committed to improving safety in the ground or airmedicaltransportcommunity.

3. A member in good standing with the InternationalAssociation of Flight & Critical Care Paramedics(IAFCCP).

4. Completed online application, two short essayquestions, a letter of support from your supervisor,andyourrésuméorCV.

5. CommitmenttocompleteSMTAcourseworkforyears1and2.

ToApply

Accessthescholarshipapplicationattimhynesfoundation.org

TheInternationalAssociationofFlight&CriticalCareCareParamedicsisastrategicpartneroftheTHF