Poway CERT 2022 Application

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* 1. What is your First and Last name? (please include both first and last)

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* 2. What is your email address?

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* 3. What is your full address? (please include city and zip code)

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* 4. What is your cell phone number?

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* 5. Attendance is required at each class during the academy. Date of the classes are TBD at this time. By applying for this course, you will be notified once the dates are finalized. We apologize for not having the exact dates at this time.

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* 6. As a member of CERT, can you commit to participating in no less than two events each calendar year?

Yes

No

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* 7. How did you hear about Poway CERT?

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* 8. Why would you like to join CERT?

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* 9. Please note that you will be required to pass an FBI and DOJ background check to be part of the team. Fingerprints will be taken at the end of the 5-week training. (no need to make a comment here, I just wanted to include this requirement in the application).

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* 10. Do you have any questions?