CERT


:: CERT Training Registration Form BASIC COURSE
COMMUNITY EMERGENCY RESPONSE TEAM (C.E.R.T.) 2015
BASIC COURSE REGISTRATION.  $15.00 COURSE FEE REQUIRED
Click here for advanced course registration

Personal Information (All information is required)

First Name:
Last Name:
Birth Date:
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.) 2012 BASIC COURSE SCHEDULE 
Please select/click on the class you are registering
for below before you click submit. 

Problems Registering call (951) 320-8112

BASIC COURSE SCHEDULE - MAY 2015
MUST ATTEND ALL SESSIONS TO RECEIVE FEMA CERTIFICATE
Fri. MAY 1, 2015  - 6:00 pm - 9:00 pm
Sat. MAY 2, 2015  - 8:00 am - 5:00 pm
Sun. MAY 3, 2015  -  8:00 am - 5:00 pm