:: 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 the class you are registering for below before you click submit. 
Problems Registering call (951) 320-8112

BASIC COURSE SCHEDULE - FEBRUARY 2015 
*RIVERSIDE CITY EMPLOYEES ONLY  - CLASS IS FULL
MUST ATTEND ALL SESSIONS TO RECEIVE FEMA CERTIFICATE & CERT BACKPACK
Thurs. Feb. 5, 2015  9:00 am - 12:00 noon
Tues. Feb. 10, 2015  9:00 am - 12:00 noon
Thurs. Feb. 12, 2015  9:00 am - 12:00 noon
Tues. Feb. 17, 2015  9:00 am - 12:00 noon
Thurs. Feb. 19, 2015  9:00 am - 12:00 noon
Tues. Feb. 24, 2015  9:00 am - 12:00 noon
Thurs. Feb. 26, 2015  9:00 am - 12:00 noon
BASIC COURSE SCHEDULE -MARCH 2015   
Fri. MARCH 6, 2015   6:00 pm - 9:00 pm
Sat. MARCH 7, 2015    8:00 am - 5:00 pm
Sun. MARCH 8, 2015   8:00 am - 5:00 pm
MUST ATTEND ALL SESSIONS TO RECEIVE FEMA CERTIFICATE & CERT BACKPACK
 

 

 
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