Participation Level

Complete this questionnaire after you finished conducting your exercise as an individual or as a neighborhood group. Your feedback is very important and will help to improve events like this and preparedness efforts throughout the community. Thank you!

* 1. Group/Individual Name:

* 2. Neighborhood Command Post Address (If you don’t have a Command Post yet, use the address where you conducted your drill):

* 3. Total # of Participants at Your Site During the Citywide Exercise:

* 4. # of Participants who were CERT Trained (Who have ever taken any CERT class)

* 5. # of Participants who were not CERT Trained (Who have never taken any CERT class)

* 6. # of Participants who reached their Out-of-Area Contacts:

* 7. # of Participants who received a BENS text-message

* 8. # of Participants who heard the 1610 AM Radio Message