Become a member of the Avalon CERT Team

Requirements:

• Must be at least 18 years of age.
• Live or work in Avalon.
• Committed in attending community events.

If you would like to register than please fill out the form below and click submit:

Name *

First

Last

Email *

Gender

Date of Birth

Landline Phone number

cell phone

other phone

Residence Address

I have lived or worked in Avalon since:

Current or past Occupation

Employer

Business Address

Business phone

Emergency Notification: name

phone

Have you had any Emergency Response Training?

Please list any other pertinent background information (business, education, and community involvement)

Comment or Message *

Name

Submit