CERT


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

Personal Information (All information is required

First Name:
Last Name:
MUST BE AT LEAST 17 YEARS  OLD
PARENT - LEGAL GUARDIAN SIGNATURE REQUIRED
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

2017 CERT BASIC COURSES WILL BE POSTED
IN JANUARY  CHECK BACK THEN