Haltom City CERT Basic Training Interest Form
Thank you for your interest in our CERT program!
  • Seats are limited, so a spot in the class is not guaranteed. You will be given more details at least 2 weeks before class starts. Typically, we hold one training in the spring and one in the fall.
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First name *
Last name *
Address (including City, State, & zip code) *
Primary phone number *
Secondary phone number
Email address *
Are you a current Haltom City CERT member? *
What is your T-shirt size? *
Are you bilingual? If yes, what languages do you speak, write, or read? *
Do you have any dietary restrictions? *
Do you have a disability? If yes, please list any functional access needs you have. *
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