Sign Up

CPR CERT Sign-up

Please send this information in a separate email to info@cooper-cert.org

*First Name:
*Last Name:
*E-Mail Address:
Telephone:
*Street Address:
*Interested in (list all that apply):

• Receive Newsletters and Email Announcements

• Becoming a Block Volunteer

• CERT Training

• Other Volunteering

• Serving on Steering Committee

Other Comments or Questions

*Starred items are required.