CERT


:: CERT Training Registration Form BASIC COURSE
COMMUNITY EMERGENCY RESPONSE TEAM (C.E.R.T.) 2018
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? 
STEM LEAPS
HIGH SCHOOL ATTENDING?
Felony Convictions (yes*/ no)
*Conditional Participation
COMMUNITY EMERGENCY RESPONSE TEAM (C.E.R.T.) 2018 BASIC COURSE SCHEDULE 
Please select/click on the class you are registering
for below before you click submit. 

Problems Registering email Gina Perez at gperez@riversideca.gov

MUST LIVE/ WORK IN RIVERSIDE & BE 18 YEARS OLD-

CERT BASIC COURSE IS FULL- NOVEMBER 2-4, 2018 
FRIDAY NOV. 2, -  6:00 PM - 9:00 PM
SATURDAY NOV 3, - 8:00 AM - 5:00 PM
SUNDAY NOV 4, 8:00 AM - 5:00 PM

MUST ATTEND ALL SESSIONS PER COURSE FOR FEMA CERTIFICATE OF COMPLETION