CERT Train the Trainer (2 Days); Monday and Tuesday, August 2-3, 2021

Please answer the following questions to register your enrollment to attend. This information will be used for documentation of those participating in the training and in the generation of completion certificates. **Prerequisite to attend - Must have taken the CERT Basic Course – Please note that exceptions may be made for participants with a verifiable first-responder background who have taken the FEMA online CERT IS-317 course, and those with a letter of recommendation to attend from a sponsoring agency. These exceptions are made on a case-by-case basis at the discretion of the State CERT Coordinator.

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* 1. Name (First and Last)

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* 2. Address

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* 3. Phone Number 1

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* 4. Email Address

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* 5. Agency/Organization Represented

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* 6. If traveling from out of town to attend, what is the distance of your travel (N/A if not applicable)?

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* 7. Which prerequisite requirements do you meet to qualify for this course?

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* 8. Do you have any dietary restrictions? If so, please provide details. 

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* 9. Additional Comments:

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