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Community Emergency Response Team

"CERT is about readiness, people helping people, safety, and doing the greatest good..."

Join Our Team!

Just fill out the application below to enroll in upcoming CERT trainings.

Okaloosa County CERT Application

The information provided on this form is for Official Use Only and protected by the Privacy Act of 1974.

This information is requested for the purpose of organizing volunteers of the Okaloosa County CERT program. This information will not be utilized or released for any other purpose without your expressed written permission unless required by law.

**All CERT members are required to pass a basic background check.**

Last Name:
First & Middle Name:
Current Street Address:
City, Zip Code:
Date of Birth:
Home Phone:
Work Phone:
Mobile Phone:
Primary Email Address:
Secondary Email Address:
Emergency Contact Name & Relationship:
Emergency Contact Address:
Emergency Contact Phone:
How did you first learn of CERT?:
		Prefer Weekend Classes
		Prefer Weeknight Classes
Questions or Comments: