AED Donation Application
Our Dedication to protecting our youth extends into our AED Donation Program. We have been selecting various community venues, and supplying them with AED (Automated External Defibrillator). 
To request an AED, please complete the application. All applications will be reviewed by our board, and we will make a decision within 6-8 weeks of receiving the completed application.
Organization Name:
Organization Website:
Mailing Address:
Contact Name:
Best Email Address:
Best Phone Number:
I have read and agree to the Responsibility Terms of Use below for this application.
AED Package Contents:
  • Cardiac Science Powerheart G5 AED with one set adult pads
  • Carry Sleeve
  • RespondER Premium AED/CPR Pack
  • ​Standard Wall Cabinet
  • ​3D AED Wall Sign
  • ​AED Window/Wall Decal
  • ​AED Check Tag
Responsibility Terms and Conditions
1.Registration: Each new AED must be registered with:

A.)The AED manufacturer (instructions included with the AED)
B.)Local EMS providers (police, fire, and emergency responders)
By submitting above, you agree to register your AED with the above mentions.

2.Maintenance: AEDs need to be checked routinely, monthly inspections are recommended to ensure they are in proper working condition. Every three years the battery will need to be replaced, and every four years or after use the pads will need replaced.
By submitting above, you agree to keep the required maintenance up to date.

3.Training: Every staff member of your organization should be trained in recognizing the signs of Sudden Cardiac Arrest and how to use the AED.
By submitting above, you agree to have training for your staff members.

4.Access: Quick access to the AED is crucial to save lives. The AED cabinet must be mounted in a visible, accessible location. The 3D “AED” sign will also be included with your package and should be mounted above the cabinet. If the AED will be carried with your group, it must be in its case at all times.
By submitting above, you agree to have easy access to the AED with the proper signage.

5.Foundation Support: Our foundation relies solely on support from generous donors and from the community. We ask that you help promote The Alyssa Dressler Foundation donation in social media, newsletter, etc. We must be notified if the AED has been used in an emergency.
By submitting above, you agree to support the donation from The Alyssa Dressler Foundation
**Please note this donation is only for the organization that is making the request. 
We request that you promptly return the AED to The Alyssa Dressler Foundation if the organization disbands.**
Feel Free To Download & Email The Application As Well 
Email to:
The Alyssa Dressler Foundation
126 Fair Oak Road
Selinsgrove, PA 17870


Copyright © 2018, The Alyssa Dressler Foundation is a 501(c)(3) Non-Profit Organization. 
All rights reserved. 
Privacy Policy | Terms of Use