If you would like to register for an upcoming CERT training class, please complete and submit this registration form.

Contact Information

First Name:*

Last Name:*

Address:*

City:*

State:*

Zip Code:*

Phone Number:*

Email Address:

Registration Information

Please indicate which session you would like to register for:*

By submitting this form, I agree to participate in the 23-hour Los Gatos/Monte Sereno Community Emergency Response Team (CERT) Training Course. I understand that only those who attend all classroom sessions and the hands on training exercise will receive a graduation certificate and a CERT vest and hard hat. I understand the cost for this 23-hour program is $30 per person for residents of incorporated Los Gatos and Monte Sereno, and $50 for residents of other cities and unincorporated areas of Santa Clara and Santa Cruz Counties.*

Yes

No

For more information about the CERT program, please call the CERT Office at (408) 399-5722.