If you are interested in attending one of our CERT classes or have other concerns to discuss with
our staff please fill out the form below. A Hollywood CERT Staff Member will contact you soon.
Click here to send an email
Applicants must be at least 18 years old and are subject to
a background check prior to acceptance into the program.

______Enter your contact information:

(Suite, Apt)
State: Zip Code:
( ) -  Ext:

______How Did You Hear About Hollywood CERT?
CERT Member
Radio / TV
Newspaper
City Meeting
City-Sponsored Event
Other Source

Please Specify Other Source:
______Choose Item(s) of Interest:
Join Hollywood CERT
CPR Re-Certification Request - (current members only)
Personal Info Change/Update - (enter changes/updates below)
Contact Me - (I would like to discuss/learn more)
Add new Organization to "Links" page (enter info below)
Other - (Please enter "Other" questions concerns below)

Enter questions / comments below:

To submit this form successfully (and for security reasons)
you must enter the security code into the box provided:

captcha image
Copyright © City of Hollywood / CERT Team, 2008. All rights reserved - Disclaimer