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Amherst CERT - Application for CERT Membership
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COMPLETE AND SUBMIT THE BELOW APPLICATION TO JOIN THE AMHERST CERT TEAM!
Are You Over 18 Years Old?
-- Select One --
Professional or Special Skills
Select All That Apply
Other Skills Or Relevant Info About You
Languages Other Than English
Age (you must be at least 14 years of age)
-- Select One --
18 or Older
Other Contact Information
Emergency Contact Name
Emergency Contact Phone Number
Acknowledge and Agree
I agree to the following:
To participate in required trainings
To agree to a Criminal Offender Record Information (CORI) Check and a Sex Offender Registry Information (SORI) check
To read and abide by guidelines set in the CERT Policy and Procedures
To sign the CERT Code of Conduct
To sign the CERT Confidentiality Agreement
To authorize the verification of the information provided on this form
Type Your Full Name Below If Everything Contained In This Form Is Accurate
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