Submission Form for the Directory of Community Emergency Response Training (CERT) Programs by State

A representative of the sponsoring agency sponsoring CERT should submit the requested information. Sponsoring agency refers to a local government jurisdiction or its designated representative that is conducting the CERT program.

Please provide the requested information (required fields in red) about your Neighborhood or Community Emergency Response Team program.

If you have any problems with completing this form, please contact us at citizencorps@dhs.gov

CERT Information:

Name of your CERT Program
Website Address
Description:
Please provide a brief description of your program, including any goals ad objectives.

Sponsoring Organization/Office:

This is a local elected leader, a representative of a local emergency response organizations, or your Citizen Corps Council. Only the sponsoring organization/office name will appear on the website, not the contact person's name.

Sponsoring Organization/Office Name
Street Address
Street Address cont.
City
State
Zip -

Contact at Sponsoring Organization/Office:

First Name
Middle Initial
Last Name
Title
Email Address
Confirm Email
Telephone - -   Ext:

CERT Program Jurisdiction:

Area Served by your CERT Program

Please describe the geographic boundary served by your CERT Program. This description will be included in your web posting to help people find the appropriate CERT program for where they live or work, e.g. Baldwin County, District 11, Southwest Tri-County area, City of Coral Gables.

State:   Area:
Geographic Boundary
 A county or counties;   A designated city, town, or local area;   A tribal area; 
Available Jurisdictions


Selected Jurisdictions