Community Emergency Response Team (CERT)

Request for Information

Please submit your contact information below to learn more about training dates and application requirements for Irvine CERT trainings. CERT trainings in Irvine are offered to those who live or work within City boundaries.

I AM A:

Adult (18 or over)

Teen (current high school student)

Prefer to attend Mandarin CERT

FIRST NAME

LAST NAME

ADDRESS

CITY

STATE

ZIP

PHONE

ALTERNATE PHONE

HOW / WHERE DID YOU HEAR ABOUT OUR PROGRAM?

REASON FOR YOUR INTEREST IN THIS PROGRAM: