Recognition submitting for: (One form must completed for each individual) CERT - Intermediate CERT - Advanced Name of CERT volunteer: (As it should appear on any certificate awarded) Name of CERT program: CERT Intermediate – Please select the courses that have been completed to meet the requirements of the CERT – Intermediate program and attach course certificates to provide proof of completion. Prerequisite: 20 hour Basic CERT Course Required Courses: IS 22 Are You Ready – IS 100 Introduction to Incident Command – IS 394 Protecting your Home or Small Business – IS 700 National Incident Management System – IS 288 Role of Volunteer Organizations in Emergency Management – Current CPR/AED Certification Elective Courses: (Minimum of 5) IS 29 Public Information Officer Awareness – IS 55 Household Hazardous Materials A Guide for Citizens – – IS 101 Deployment Basics – Advanced First Aid CERT Animal Response Module I and II Damage Assessment Hazardous Materials Awareness NASAR Introduction to Search and Rescue NASAR Fundamentals of Search and Rescue
Recognition submitting for: (One form must completed for each individual) CERT - Intermediate CERT - Advanced Name of CERT volunteer: (As it should appear on any certificate awarded) Name of CERT program: CERT – Intermediate Please select the courses that have been completed to meet the requirements of the CERT – Intermediate program and attach course certificates to provide proof of completion. Prerequisite: 20 hour Basic CERT Course Required Courses: IS 22 – Are You Ready IS 100 – Introduction to Incident Command IS 394 – Protecting your Home or Small Business IS 700 – National Incident Management System IS 288 – Role of Volunteer Organizations in Emergency Management Current CPR/AED Certification Elective Courses: (Minimum of 5) IS 29 – Public Information Officer Awareness IS 55 – Household Hazardous Materials – A Guide for Citizens IS 101 – Deployment Basics Advanced First Aid CERT Animal Response Module I and II Damage Assessment Hazardous Materials Awareness NASAR Introduction to Search and Rescue NASAR Fundamentals of Search and Rescue
CERT%20Training%20Recognition%20Submission%20Form.docx