CERT


:: CERT Training Registration Form BASIC COURSE
COMMUNITY EMERGENCY RESPONSE TEAM (C.E.R.T.) 2017
BASIC COURSE REGISTRATION.
 
Click here for advanced course registration

Personal Information (All information is required

First Name:
Last Name:
MUST BE AT LEAST 18 YEARS  OLD
Birth Date:
MUST LIVE-WORK- IN THE CITY OF RIVERSIDE
Address:
City:
State:
Zip Code:
 Home Phone:
(XXX) XXX-XXXX
Work Phone:
(XXX) XXX-XXXX
Cell Phone:
(XXX) XXX-XXXX
Email Address:
Physical Limitations:
**Describe special
accommodations
needed if any? 
Volunteer Organizations
you Belong to:  
Felony Convictions (yes*/ no)
*Conditional Participation
 
 
COMMUNITY EMERGENCY RESPONSE TEAM (C.E.R.T.) 2017 BASIC COURSE SCHEDULE 
Please select/click on the class you are registering
for below before you click submit. 

Problems Registering call (951) 320-8112

CLASS IS FULL - DEC  2017- MUST LIVE/ WORK IN RIVERSIDE & BE 18 YEARS OLD

Fri. Dec. 1 - 6 pm –  9 pm     Sat. Dec 2 - 8 am -5 pm    Sun.  Dec 3 - 8:00 am - 5:00 pm

MUST ATTEND ALL SESSIONS PER COURSE FOR FEMA CERTIFICATE OF COMPLETION