Basic CERT Course Evaluation and Make-Up Questionaire

Name
First Last
Email
Phone
Which units do you need a make-up for or you would like to know more about?*
- Unit 1: Disaster Preparedness
- Unit 2: Fire Safety and Utility Controls
- Unit 3: Disaster Medical Operations Part I
- Unit 4: Disaster Medical Operations Part II
- Unit 5: Light Search and Rescue
- Unit 6: CERT Organization
- Unit 7: Disaster Psychology
- Unit 8: Terrorism and CERT
What day(s) and time(s) are you most available for an in-person make up?*
Day(s) of the Week (Mon, Tue etc.) Time(s) of Day
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Enter an alternate Email address:
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Terms and Conditions:
- I Agree.

Day(s) of the Week (Mon, Tue etc.)	Time(s) of Day